Seman Kedir Ousman|Ibrahimu Mdala|Viva Combs Thorsen|Johanne Sundby|Jeanette H. Magnus
Social Determinants of Antenatal Care Service Use in Ethiopia: Changes Over a 15-Year Span
St. Paul's Hospital Millennium Medical College|University of Oslo|University of Oslo|University of Oslo|University of Oslo|Tulane University|University of Oslo
background improving maternal health ethiopia major public health challenge international studies indicate possible improve maternal health outcomes action social determinants health sdh study aimed explore sdh influence antenatal care anc utilization ethiopia time methods study used data nationwide surveys conducted ethiopian central statistical agency csa orc macro international usa 2005 2011 2016 negative binomial random effects cluster level used model number anc visits whereas multilevel binary logistic regression modelled binary responses relating whether woman least 4 anc visits model estimates obtained statistical software stata se 15 using restricted maximum likelihood method results although median number anc visits significantly increased 2005 2016 majority women obtain four anc visits pregnancy recommended odds least four anc visits significantly lower among women 20 years living rural areas higher birth order muslim contrast higher educational attainment higher socioeconomic status exposure mass media selfreporting decision empowerment significantly associated least four anc visits conclusion use anc visits driven mostly social determinants health rather individual health risk importance various sdhs needs recognized ministry health policy program managers key driving force behind countrys challenges reaching targets health agenda related maternal health particularly related recommended number anc visits