Evidence map›Paper›PMID 40847208›Full record

ArticleInternational journal of health economics and management2025

Socioeconomic inequities impacting complete continuum of maternal healthcare service utilisation over time in Ethiopia.

Ayal Debie, Molla M Wassie, Annabelle Wilson, Claire T Roberts, Jacqueline H Stephens

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Article in International journal of health economics and management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Ayal DebieCollege of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia. tefe0004@flinders.edu.au.ORCID http://orcid.org/0000-0002-5596-8401
Molla M WassieCollege of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.ORCID http://orcid.org/0000-0002-3565-2397
Annabelle WilsonCollege of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.ORCID http://orcid.org/0000-0003-4308-8113
Claire T RobertsCollege of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.ORCID http://orcid.org/0000-0002-9250-2192
Jacqueline H StephensCollege of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.ORCID http://orcid.org/0000-0002-7278-1374

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo quantify socioeconomic inequities of complete continuity of maternal healthcare service over time using Ethiopian Demography and Health Survey data from 2011 to 2019.

methodsA total of 10,768 women who had at least one antenatal care visit during their most recent childbirth were included for the analysis. Concentration index and concentration curve were used to assess wealth-based inequities. A generalized linear model with binomial distribution and a logit link function was used to decompose the Erreygers concentration index and measure each determinant's contribution.

resultsComplete continuum of maternal health service utilization in 2011, 2016, and 2019 among the wealthiest women were 25.9%, 33.7%, and 50.8%, respectively. In contrast, the corresponding continuum of maternal health service utilisation was 3.0%, 6.1%, and 11.2% among the lowest wealth categories. The Erreygers concentration indices of complete continuum of maternal health service utilization in 2011, 2016, and 2019 surveys were 0.203, 0.195, and 0.311, respectively, with the highest inequity observed in 2019. Concentration curves in each survey showed a pro-rich distribution of complete continuum of maternal health service utilisation. A unit percentage change in women's education, early initiation of antenatal care, being informed about pregnancy-related complications, and blood pressure monitoring during pregnancy increased their probability of completing continuum of maternal health service utilization. Specifically, a 1% increase in the proportion of secondary or higher education corresponded to a 0.02%, 0.01%, and 0.07% increase in the probability of completing continuum of maternal health service utilisation in 2011, 2016, and 2019, respectively. Conversely, in 2011, a 1% increase in the proportion of rural women and those with more than four parities led to a 0.11% and 0.05% decrease in the probability of completing continuum of maternal health service utilisation, respectively.

conclusionComplete continuum of maternal health service utilization was more likely amongst women without disadvantage, demonstrating wealth-based inequities in continuum of maternal health service utilization continue in Ethiopia. In this analysis, continuum of maternal health service utilisation remains inelastic across all surveys highlightsits the service is an essential form of care for women. Provision of maternal healthcare services targeting women from low household wealth status, residing in rural communities, and uneducated women must be prioritised by policymakers.

Indexed as

Continuity of Patient CareHealthcare DisparitiesMaternal Health ServicesPatient Acceptance of Health CareAdolescentAdultEthiopiaFemaleHealth Services AccessibilityHumansMiddle AgedPregnancyPrenatal CareSocioeconomic FactorsYoung AdultContinuumEquityEthiopiaMaternal healthcare service

Identifiers

PMID40847208
PMCPMC12685972

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