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Tytuł pozycji:

Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation.

Tytuł:
Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation.
Autorzy:
Alamneh TS; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Teshale AB; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Yeshaw Y; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.; Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Alem AZ; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ayalew HG; Department of midwifery, school of nursing and midwifery, college of medicine and health sciences, Wollo University, Dessie, Ethiopia.
Liyew AM; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Tessema ZT; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Tesema GA; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Worku MG; Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia.
Źródło:
PloS one [PLoS One] 2022 Apr 22; Vol. 17 (4), pp. e0266490. Date of Electronic Publication: 2022 Apr 22 (Print Publication: 2022).
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms:
Continuity of Patient Care*
Health Services Accessibility*
Adult ; Educational Status ; Ethiopia ; Female ; Health Surveys ; Humans ; Spatial Analysis
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Entry Date(s):
Date Created: 20220422 Date Completed: 20220426 Latest Revision: 20231101
Update Code:
20240104
PubMed Central ID:
PMC9032438
DOI:
10.1371/journal.pone.0266490
PMID:
35452475
Czasopismo naukowe
Background: Although Ethiopia had made a significant change in maternal morbidity and mortality over the past decades, it remains a major public health concern. World Health Organization designed maternal continuum of care to reduce maternal morbidity and mortality. However, majority of the mothers didn't utilize the maternal continuum of care. Therefore, this study aimed to assess the spatial distribution of incomplete utilization of maternal continuum of care and its associated factors in Ethiopia.
Methods: This study was based on 2016 Demographic and Health Survey data of Ethiopia. A total weighted sample of 4,772 reproductive aged women were included. The study used ArcGIS and SaTScan software to explore the spatial distribution of incomplete utilization of maternal continuum of care. Besides, multivariable Generalized Estimating Equation was fitted to identify the associated factors of incomplete utilization of maternal continuum of care using STATA software. Model comparison was made based on Quasi Information Criteria. An adjusted odds ratio with 95% confidence interval of the selected model was reported to identify significantly associated factors of incomplete utilization of maternal continuum of care.
Results: The spatial analysis revealed that incomplete utilization of maternal continuum of care had significant spatial variation across the country. Primary clusters were detected at Somali, North-Eastern part of Oromia, and East part of Southern Nation Nationalities while secondary clusters were detected in the Central Amhara region. In multivariate GEE, rural residency, secondary education, higher education, Protestant religious follower's, Muslim religious follower's, poorer wealth index, richer wealth index, richest wealth index, currently working, having barriers for accessing health care, and exposure for mass media were significantly associated with incomplete utilization maternal continuum of care.
Conclusion: Incomplete utilization of maternal continuum of care had significant spatial variations in Ethiopia. Residence, wealth index, education, religion, and barriers for health care access, mass media exposure, and currently working were significantly associated with incomplete utilization of maternal continuum of care. Therefore, public health interventions targeted to enhance maternal service utilization and women empowerment in hotspot areas of incomplete utilization of maternal continuum of care are crucial for reducing maternal morbidity and mortality.
Competing Interests: The authors have declared that no competing interests exist.
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