A Skilled Antenatal Care Service Utilization and Its Association with the Characteristics of Women’s Health Development Team in Yeky District, South-West Ethiopia Multilevel Analysis

Abstract

BACKGROUND: In response to high maternal and perinatal morbidities and mortalities in Ethiopia,"Women's Health Development Army" was established to enhance utilization of skilled maternityservices including antenatal care (ANC). However, its effect on skilled ANC service utilization is not wellmeasured. Our study was aimed to assess skilled antenatal care service utilization and its association withthe characteristics of women's health development team (WHDT).METHODS: A community based cross sectional study was conducted from January to February 2015. Amulti-stage cluster sampling technique was applied, and a total of 748 women (15-49 years) who gavebirth in one year preceding the study were included in the study. Data were entered into EPI info version7 statistical software and exported to STATA version 11 for analysis. Bivariate and multilevel mixedeffects analysis techniques were applied to check for association of selected independent variables withutilization of skilled ANC.RESULTS: About 71% women received skilled ANC service at least once. A significant heterogeneitywas observed between WHDTs for skilled ANC utilization. Level-1 predictors of skilled ANC utilizationwere: preference of skilled personnel (AOR=11.0; 95%, CI, 3.02-40.04), awareness about places where toget skilled providers (AOR=51.6; 95% CI, 13.92-,190.97) and listening to radio (AOR=5.7; 95% CI, 1.46-21.94). Distance of WHDT within 2 km radius from the nearest health facility (HF) was the only level-2significant predictor of skilled ANC service utilization (AOR=8.28; 95%CI, 1.08-62.20).CONCLUSIONS: Skilled ANC service utilization is the joint effect of individual and WHDT characters.Awareness and perception creation towards skilled maternity service utilization need to be enhanced.Facilities and transport services should be more accessible towards WHDTs.