The Levels of utilization of reproductive, maternal and neonatal health services among women from pastoralist communities in Afar, Ethiopia: across-sectional survey
Background: Good-quality reproductive, maternal and neonatal health services, as well as their uptake, are key to preventing complications during pregnancy, in childbirth, and after a child is born. However, the uptake of reproductive, maternal and neonatal health services in the Afar region of Ethiopia is low.
Objective: The aim of this study to assess the extent to which reproductive, maternal and neonatal services are used by Afar women in pastoralist communities in Ethiopia, and to examine the reasons for the low uptake of these services.
Methods: A community-based cross-sectional study was conducted among 1,978 mothers with children up to the age of 24 months. Multistage sampling was employed to recruit the study participants. Multivariate logistic regression analysis was used to identify the effect of independent predictors on the utilization of reproductive, maternal and neonatal health services.
Results: The number of women who had four or more antenatal care visits, who had institutional deliveries, who had postnatal visits within seven days of giving birth, and who currently use family planning was 443(22.4%), 322(16.7%), 61(3.1%) and 107(5.4%), respectively. About one third of the women, 686 (34.7%),made good use of reproductive, maternal and neonatal health services. The incidence of using reproductive, maternal and neonatal health services was 2.8 times (AOR = 2.8; 95%CI: 2.0, 3.9) higher among educated women. Women with non-pastoralist husbands and women who could walk from their homes to the health facility within 30 minutes were 2.1 times (AOR = 2.1; 95% CI: 1.6, 2.9) and 2.6 times (AOR = 2.6; 95% CI: 2.1, 3.3), respectively, more likely to use the services than their counterparts.
Conclusions: The overall use of reproductive, maternal and neonatal health services was low. Lack of awareness about the importance of using reproductive, maternal and neonatal health services was deeply rooted in the study participants and largely accounts for the low coverage. Reproductive, maternal and neonatal health utilization was not uniform across all zones of the region, and varied depending on the educational status of women, husbandâ€™s occupation and distance from the health facility. To increase the use of reproductive, maternal and neonatal health services, suggested measures include empowering women, sharing good experience and devising context-based community-based intervention. [Ethiop. J. Health Dev.2018;32(Special Issue):34-42]
Keywords: Reproductive, maternal and neonatal health, pastoralist, Afar, Ethiopia