International Journal of Health Economics and Policy

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Improving Antenatal Care Services Utilization in Ethiopia: An Evidence–Based Policy Brief

Received: Jan. 25, 2017    Accepted: Feb. 18, 2017    Published: Mar. 09, 2017
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Abstract

The World Health Organization recommends a minimum of four antenatal care visits. However, global estimates indicate that only about half of all pregnant women receive this recommended amount of care. The objective of this evidence brief is to summarize the best available evidence describing the low levels of antenatal care service utilization in Ethiopia and to outline potential solutions to address the problem. The policy brief brings together global research evidence from systematic reviews and local evidence to inform deliberations about improving antenatal care service utilization in Ethiopia. Only 32% of Ethiopian women with live birth received at least four visits during the length of their pregnancy, which is below the global average (54%). The predominant underlying factors for the low coverage of antenatal care services include: socio-cultural and economic barriers, poor access to health services, and poor quality of antenatal care services. Potential policy options to address the need for improving antenatal care coverage and service utilization in Ethiopia include the following: (i) Behavioral Change Communication (BCC) might increase utilization of health services by pregnant mothers (ii) mobile health (mHealth) interventions probably increases the attendance of health care appointments (iii) Conditional Cash Transfer (CCT) programmes may increase antenatal care attendance since it increases health care seeking behavior.

DOI 10.11648/j.hep.20170203.14
Published in International Journal of Health Economics and Policy ( Volume 2, Issue 3, September 2017 )
Page(s) 111-117
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Antenatal Care, mHealth, Behavioral Change Communication, Conditional Cash Transfer, Ethiopia

References
[1] WHO. Commision on information and accountability for women's and children's health: Keeping promises, measuring results. Final report of the Commission. [Internet]. Geneva: WHO; 2015. Available from: http://www.everywomaneverychild.com/pages?pageid=14.
[2] UNICEF. UNICEF Data: Monitoring the situation of children and women [Internet]. 2015. Available from:https://www.data.unicef.org.
[3] WHO. Standards for Maternal and neonatal Care. Standards for Maternal and Neonatal Care, Making Pregnancy Safer. [Internet]. Geneva: WHO; 2007. Avaialable from www.who.int/making_ pregnancy_safer/publications/en.
[4] Stanton C, Armbruster D, Knight R, Ariawan I, Gbangbade S, Getachew A, et al. Use of active management of the third stage of labour in seven developing countries. Bull World Health Organ. 2009; 87 (3): 207–15.
[5] FMOH. Federal Democratic Republic of Ethiopia Ministry of Health: Health Sector Development Program IV (2010/11-2014/15). 2010.
[6] FMOH. Federal Democratic Republic of Ethiopia Ministry of Health. HSTP: Health Sector Transformation Plan (2015/16-2019/20). 2015.
[7] Supporting the Use of Research Evidence (SURE) in African Health Systems. SURE guides for preparing and using policy briefs: Clarifying the problem, Deciding on and describing options to address the problem, Identifying and addressing barriers to implementaion. avaialable from www.who.int/evidence/sure/en/.
[8] Gebreyohannes Y., Hadis M., Abay S., Ararso D., Dibaba A., Mengistu F. Improving antenatal care service utilization in Ethiopia, Dialogue Report: Ethiopian Public Health Institute, 2016.
[9] Ethiopian Central Stastical Agency (ECSA). Ethiopia Mini Demographic and Health Survey (EMDHS). 2014.
[10] UNICEF. The State of World’s Children 2016: A fair chance for every child. New York: UNICEF; 2016 [Internet]. Available from:https://www.unicef.org/publications/files/UNICEF _SOWC_2016.pdf.
[11] Heaman MI, Newburn-cook C V, Green CG, Elliott LJ, Helewa ME. Inadequate prenatal care and its association with adverse pregnancy outcomes : A comparison of indices. BMC Pregnancy Childbirth 2008; 8(15): Available from: http://www.biomedcentral.com/1471-2.
[12] Mpembeni RN, Killewo JZ, Leshabari MT, Massawe SN, Jahn A, Mushi D, et al. Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy Childbir.
[13] Tunde A, Agnes G, Gezahegn M, Magda R, Khama R, Rajiv B, ET AL. The Partnership For Maternal & Child Health: Opportunities for Africa’s Newborns. Practical data, policy and programmatic support for newborn care in Africa. 2010.
[14] Finlayson K, Downe S. Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies. PLoS Med 10 (1): e1001373. doi:10.1371/journal.pmed.1001373.
[15] Ethiopian Public Health Institute, Federal Minstry of Health Ethiopia, and ICF International. Ethiopia Service Provision Assessment Plus Survey (ESPA+). 2014.
[16] Ethiopian Health and Nutrition Research Institute. Implementaion status and client satisfaction of focused antenatal care (FANC) in Ethiopia. 2014.
[17] Momentum of Professional Researchers and Trainers PLC. Rapid Assesment of determinants, factors and opportunities to early pregnancy identification, Focused ANC, skilled birth attendance and postnatal care services utilization in Oromia region. 2015.
[18] Assfaw YT, Sebastian MS. Determinants of Antenatal Care, Institutional Delivery and Skilled Birth Attendant Utilization in Samre Saharti District, Tigray, Ethiopia. Afr J Reprod Health. 2010; 1–61.
[19] Aliy. J, Hailemariam. D. Determinants of equity in utilization of maternal health services in Butajira, Southern Ethiopia. Ethiop J Heal Dev. 2012; 26 (Specialissue1): 265–70.
[20] Girmatsion Fesseha, Mussie Alemayehu, Belachew Etana, Kiday Haileslassie, Ayalnesh Zemene. Perceived Quality of Antenatal Care Service by Pregnant Women in Public and Private Health Facilities in Northern Ethiopia. American Journal of Health Research. Vol. 2, No. 4, 2014, pp. 146-151.
[21] Amsalu Nemera Yabo, Mitsiwat Abebe Gebremicheal, Eshetu Ejeta Chaka. Assessment of Quality of Antenatal Care (ANC) Service Provision among Pregnant Women in Ambo Town Public Health Institution, Ambo, Ethiopia, 2013. American Journal of Nursing Science. Vol. 4, No. 3, 2015, pp. 57-62.
[22] United Nations Children Educational Fund Regional Office for South Asia. Strategic Communication for Behaviour and Social Change in South Asia. Nepal. 2005.
[23] Salem R, Bernstein J, and Sullivan T. “Tools for Behavior Change Communication.” INFO Reports, No. 16. Baltimore, INFO Project, Johns Hopkins Bloomberg School of Public Health, January 2008. Available from http://www.infoforhealth. org/inforeports/.
[24] Lamstein, S., T. Stillman, P. Koniz-Booher, A. Aakesson, B. Collaiezzi, T. Williams, K. Beall, and M. Anson. Evidence of Effective Approaches to Social and Behavior Change Communication for Preventing and Reducing Stunting and Anemia: Report from a System.
[25] UNICEF. Innovative Approaches to Maternal and Newborn Health. Compendium of Case Studies. [Internet]. New York; 2013. Available from: http://www.everywomaneverychild. org/images/content/files/Innovative_Approaches_MNH_Case_Studies_8-22Final-2.pdf.
[26] WHO. mHealth: New horizons for health through mobile technologies. Observatory [Internet]. Geneva; 2011;3 (112). Available from: http://www.who.int/goe/publications/ goe_mhealth_web.pdf.
[27] WHO. Towards the Development of an mHealth Strategy : A literature review. World Heal Organ Millenn village Proj. 2008: 1–62.
[28] Gurol-Urganci I, de Jongh T, Vodopivec-Jamsek V, Atun R, Car J. Mobile phone messaging reminders for at- tendance at healthcare appointments. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD007458. DOI: 10.1002/14651858. CD007458.pub3.
[29] Fiszbein A, Schady N. Conditional Cash Transfers: Reducing present and future poverty. World Bank Policy Research Report. 2013. Available from: http:// www.worldbank.org.
[30] Glassman A, Duran D, Fleisher L, Singer D, Sturke R, Angeles G, et al. Impact of Conditional Cash Transfers on Maternal and Newborn Health. J Heal Popul NUTR. 2013; 31 (4): 48–66.
[31] Lagarde M, Haines A, Palmer N. The impact of conditional cash transfers on health outcomes and use of health ser- vices in low and middle income countries. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD008137. DOI: 10.1002/14651858.CD008137.
[32] FHI. Behavior change communication (BCC) for HIV/AIDS. A strategic framework. 2002; Available from: http://www.hivpolicy.org/Library/HPP000533.pdf.
[33] Handa S, Davis B. The experience of conditional cash transfers in Latin America and the Caribbean. Dev Policy Rev. 2006; 24 (5): 513–36.
[34] Schubert B, Slater R. Social Cash Transfers in Low-Income African countries: Conditional or Unconditional? Dev Policy Rev. 2006; 24 (5): 571–8.
Cite This Article
  • APA Style

    Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, Serebe Abay, Mamuye Hadis. (2017). Improving Antenatal Care Services Utilization in Ethiopia: An Evidence–Based Policy Brief. International Journal of Health Economics and Policy, 2(3), 111-117. https://doi.org/10.11648/j.hep.20170203.14

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    ACS Style

    Yosef Gebreyohannes; Desalegn Ararso; Fasil Mengistu; Serebe Abay; Mamuye Hadis. Improving Antenatal Care Services Utilization in Ethiopia: An Evidence–Based Policy Brief. Int. J. Health Econ. Policy 2017, 2(3), 111-117. doi: 10.11648/j.hep.20170203.14

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    AMA Style

    Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, Serebe Abay, Mamuye Hadis. Improving Antenatal Care Services Utilization in Ethiopia: An Evidence–Based Policy Brief. Int J Health Econ Policy. 2017;2(3):111-117. doi: 10.11648/j.hep.20170203.14

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  • @article{10.11648/j.hep.20170203.14,
      author = {Yosef Gebreyohannes and Desalegn Ararso and Fasil Mengistu and Serebe Abay and Mamuye Hadis},
      title = {Improving Antenatal Care Services Utilization in Ethiopia: An Evidence–Based Policy Brief},
      journal = {International Journal of Health Economics and Policy},
      volume = {2},
      number = {3},
      pages = {111-117},
      doi = {10.11648/j.hep.20170203.14},
      url = {https://doi.org/10.11648/j.hep.20170203.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.hep.20170203.14},
      abstract = {The World Health Organization recommends a minimum of four antenatal care visits. However, global estimates indicate that only about half of all pregnant women receive this recommended amount of care. The objective of this evidence brief is to summarize the best available evidence describing the low levels of antenatal care service utilization in Ethiopia and to outline potential solutions to address the problem. The policy brief brings together global research evidence from systematic reviews and local evidence to inform deliberations about improving antenatal care service utilization in Ethiopia. Only 32% of Ethiopian women with live birth received at least four visits during the length of their pregnancy, which is below the global average (54%). The predominant underlying factors for the low coverage of antenatal care services include: socio-cultural and economic barriers, poor access to health services, and poor quality of antenatal care services. Potential policy options to address the need for improving antenatal care coverage and service utilization in Ethiopia include the following: (i) Behavioral Change Communication (BCC) might increase utilization of health services by pregnant mothers (ii) mobile health (mHealth) interventions probably increases the attendance of health care appointments (iii) Conditional Cash Transfer (CCT) programmes may increase antenatal care attendance since it increases health care seeking behavior.},
     year = {2017}
    }
    

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    AU  - Yosef Gebreyohannes
    AU  - Desalegn Ararso
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    JF  - International Journal of Health Economics and Policy
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    AB  - The World Health Organization recommends a minimum of four antenatal care visits. However, global estimates indicate that only about half of all pregnant women receive this recommended amount of care. The objective of this evidence brief is to summarize the best available evidence describing the low levels of antenatal care service utilization in Ethiopia and to outline potential solutions to address the problem. The policy brief brings together global research evidence from systematic reviews and local evidence to inform deliberations about improving antenatal care service utilization in Ethiopia. Only 32% of Ethiopian women with live birth received at least four visits during the length of their pregnancy, which is below the global average (54%). The predominant underlying factors for the low coverage of antenatal care services include: socio-cultural and economic barriers, poor access to health services, and poor quality of antenatal care services. Potential policy options to address the need for improving antenatal care coverage and service utilization in Ethiopia include the following: (i) Behavioral Change Communication (BCC) might increase utilization of health services by pregnant mothers (ii) mobile health (mHealth) interventions probably increases the attendance of health care appointments (iii) Conditional Cash Transfer (CCT) programmes may increase antenatal care attendance since it increases health care seeking behavior.
    VL  - 2
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Author Information
  • Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Section