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Reproductive Health
Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Study protocol

Inequities in maternal health services utilization in Ethiopia 2000–2016: magnitude, trends, and determinants

Authors: Emebet Gebre, Alemayehu Worku, Fawole Bukola

Published in: Reproductive Health | Issue 1/2018

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Abstract

Background

Inequities in maternal health services utilization constitute a major challenge in maternal mortality reduction in Ethiopia. We sought to assess magnitude, trends, and determinants of inequities in maternal health services utilization in Ethiopia from 2000 to 2016.

Methods

The study utilized data from the 2000 and 2016 Ethiopia Demographic and Health Surveys, which were done based on a cross sectional survey design. The wealth-related inequities were assessed by concentration curve and horizontal inequity indices. Trends in inequities were assessed by comparing the concentration indices of maternal health services utilization variables between the 2000 and 2016 surveys using Wagstaff two groups concentration indices comparison method. Finally, the inequities were decomposed into its contributing factors using Wagstaff method of analysis.

Results

Wealth-related inequities were significantly high in 2016: with horizontal inequities indices and residual regression error of antenatal care, skilled birth attendance, and postnatal care service utilization (− 0.09 and − 0.01), (− 0.06 and 0.01), and (− 0.11 and 0.0001), respectively. These indices increased significantly in 2016 when it is compared with the 2000 indices’ with the respective concentration indices difference of − 0.05, 0.05, and − 0.07. The related all p-values were < 0.0001. The main determinants of inequities were low-economic status, illiteracy, rural residence, no occupation, and fewer accesses to mass media.

Conclusions

In Ethiopia, maternal health services utilization inequities were significantly high and increased in 2016 compared to 2000. Women who are poor, rural resident, uneducated, unemployed, and fewer mass media exposed are the most disadvantaged. Targeting maternal health interventions for the underserved women is essential to reduce maternal mortality in the country.
Appendix
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Footnotes
1
Maternal mortality is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from the accidental or incidental cause [59].”
 
2
Inequality in health care is differences in the health care utilization by clusters or person [60, 61]. Whereas, equity in health cares: “is defined as equal access to available care for equal need, equal utilization for equal need, and equal quality of care for all.”
 
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Metadata
Title
Inequities in maternal health services utilization in Ethiopia 2000–2016: magnitude, trends, and determinants
Authors
Emebet Gebre
Alemayehu Worku
Fawole Bukola
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0556-x

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