ArticlePloS one2022
Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Utilisation and associated socio-demographic factors related to the maternal continuum of care in sub-Saharan Africa: A systematic review and meta-analysis.Journal of global health · 2024Pooled it
- Coverage and determinants of hepatitis B virus vaccine uptake among children aged 12-36 months in Ethiopia: an analysis of the 2016 Ethiopian Demographic and Health Survey.International health · 2026Article
- Gender dynamics affecting women's uptake of maternal health service in agrarian and pastoral settings in Ethiopia: a community-based cross-sectional study.Reproductive health · 2026Article
- The lived experience, perceptions, and barriers of continuum of maternal health care services utilization: a qualitative study.BMC pregnancy and childbirth · 2026Article
- Healthcare access barriers and maternal healthcare service uptake in 14 sub-Saharan African countries (2017-2021): a propensity score matched analysis.BMJ public health · 2026Article
- Article
- Problems with accessing healthcare and associated factors among reproductive-age women in Somaliland: a multilevel analysis of data from the 2020 SLDHS.Frontiers in global women's health · 2026Article
- Barriers to healthcare access among women in sub-Saharan Africa: A pooled analysis of multi-country DHS data (2019-2023).PloS one · 2026Article
- Optimizing machine learning models for predicting health service access and determinants among pregnant women in rural Ethiopia.Scientific reports · 2025Article
- Spatial distribution and determinants of health care access barriers among female Pakistan youths: spatial and multilevel regression analysis.BMC health services research · 2025Article
- Exploring the Multilevel Determinants of Suboptimal Maternal and Child Continuum of Care in Indonesia.Maternal and child health journal · 2025Article
- Mapping traditional birth attendance in sub-Saharan Africa between 2012 and 2023: analysis of data from demographic and health surveys.AJOG global reports · 2025Article
- Strengthening primary health care in Ethiopia: A scoping review of successes, challenges, and pathways towards universal health coverage using the WHO monitoring framework.PLOS global public health · 2025Article
- Leveraging machine learning to identify determinants of zero utilization of maternal continuum of care in Ethiopia: Insights from SHAP analysis and the 2019 mini DHS.PLOS global public health · 2025Article
- Decomposing socioeconomic inequality in skilled birth attendant utilization in Ethiopia: A secondary data analysis.PloS one · 2025Article
- Spatial Access to Continuous Maternal and Perinatal Health Care Services in Low-Resource Settings: Cross-Sectional Study.JMIR public health and surveillance · 2024Article
- Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review.BMC women's health · 2024Article
- Spatial variation of skilled birth attendance and associated factors among reproductive age women in Ethiopia, 2019; a spatial and multilevel analysis.Frontiers in global women's health · 2024Article
- Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey.Frontiers in public health · 2024Article
- State of the maternal healthcare continuum in Guinea, awaiting the next Demographic and Health Survey: the case of the five communes of Conakry in 2022.Frontiers in reproductive health · 2024Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough 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.
methodsThis 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.
resultsThe 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.
conclusionIncomplete 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.
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