ArticleBMJ open2021
Distance, difference in altitude and socioeconomic determinants of utilisation of maternal and child health services in Ethiopia: a geographic and multilevel modelling analysis.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Co-Occurrence of Malaria, Pneumonia, and Diarrheal Disease Among Households: A Cohort Study in Rural Western Uganda.Tropical medicine & international health : TM & IH · 2026Article
- Knowledge of obstetrical fistula and its associated factors among reproductive-age women in Ejere Woreda, West Shewa Zone, Oromia Region, Ethiopia: a community-based study.Frontiers in global women's health · 2025Article
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- Well-Being and Healthcare Inequality on Bulon-Don Island in Southern Thailand-Results of a Pre-Intervention Field Survey.Children (Basel, Switzerland) · 2024Article
- Wealth disparities in maternal health service utilization among women of reproductive age in Ethiopia: findings from the mini-EDHS 2019.BMC health services research · 2024Article
- What are the associated factors of low husbands/partners independent decision-maker in women's contraceptive use decision-making process in Ethiopia? Multilevel analysis.BMC public health · 2024Article
- Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review.International journal of environmental research and public health · 2024Article
- Article
- Determinants of maternal healthcare utilisation among pregnant women in Southern Ethiopia: a multi-level analysis.BMC pregnancy and childbirth · 2023Article
- Article
- Prevalence of adequate postnatal care and associated factors in Rwanda: evidence from the Rwanda demographic health survey 2020.Archives of public health = Archives belges de sante publique · 2022Article
- The effects of geographical accessibility to health facilities on antenatal care and delivery services utilization in Benin: a cross-sectional study.Reproductive health · 2021Article
- Caregivers' and Health Extension Workers' Perceptions and Experiences of Outreach Management of Childhood Illnesses in Ethiopia: A Qualitative Study.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe assessed whether geographic distance and difference in altitude between home to health facility and household socioeconomic status were associated with utilisation of maternal and child health services in rural Ethiopia.
designHousehold and health facility surveys were conducted from December 2018 to February 2019.
settingForty-six districts in the Ethiopian regions: Amhara, Oromia, Tigray and Southern Nations, Nationalities, and Peoples.
participantsA total of 11 877 women aged 13-49 years and 5786 children aged 2-59 months were included. OUTCOME MEASURES: The outcomes were four or more antenatal care visits, facility delivery, full child immunisation and utilisation of health services for sick children. A multilevel analysis was carried out with adjustments for potential confounding factors.
resultsOverall, 39% (95% CI: 35 to 42) women had attended four or more antenatal care visits, and 55% (95% CI: 51 to 58) women delivered at health facilities. One in three (36%, 95% CI: 33 to 39) of children had received full immunisations and 35% (95% CI: 31 to 39) of sick children used health services. A long distance (adjusted OR (AOR)=0.57; 95% CI: 0.34 to 0.96) and larger difference in altitude (AOR=0.34; 95% CI: 0.19 to 0.59) were associated with fewer facility deliveries. Larger difference in altitude was associated with a lower proportion of antenatal care visits (AOR=0.46; 95% CI: 0.29 to 0.74). A higher wealth index was associated with a higher proportion of antenatal care visits (AOR=1.67; 95% CI: 1.02 to 2.75) and health facility deliveries (AOR=2.11; 95% CI: 2.11 to 6.48). There was no association between distance, difference in altitude or wealth index and children being fully immunised or seeking care when they were sick.
conclusionAchieving universal access to maternal and child health services will require not only strategies to increase coverage but also targeted efforts to address the geographic and socioeconomic differentials in care utilisation, especially for maternal health. TRIAL REGISTRATION NUMBER: ISRCTN12040912.
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