Maternal healthcare services utilization trajectories in four regions of Ethiopia: A Latent Class Analysis

Abstract

Abstract
Background: Despite the progress made by the Ethiopian government and the international community to reduce maternal mortality, maternal mortality remains excessively high accompanied with very low levels of maternal health service utilization . This study aimed to assess the trajectories and determinants of maternal healthcare services utilization in four populous regions of Ethiopia.
Method: The study was conducted in the four populous regions of Ethiopia. The study population was mothers who had delivered in the last twelve months of the survey date. Data were extracted from the baseline data gathered via the Dagu project. Accordingly, a total of 590 women who had given birth in the 12 months preceding the survey were included in the final analysis. Seven indicator variables were included in constructing the maternal healthcare utilization variable. Latent class analysis was used to identify subgroups of maternal healthcare utilization along the continuum of care. Further, ordinal logistic regression was utilized to identify the determinants of the trajectories of maternal healthcare utilization. STATA 14 was used for data management and analysis and a 5% level of significance was used to declare statistical significance.
Results: The results of the latent class analysis indicated that about two in five of the mothers (43.9%) did not attempt to visit a health facility during pregnancy, for delivery, or for postnatal checkups. Women who utilized maternal healthcare accounted for 6.1% of the sample. The trajectory of maternal healthcare utilization indicated a significant difference between regions and religious affiliation of women. Educated women, women of higher socioeconomic status, and women with better birth preparedness and complication readiness were found to be in the highest classes of maternal health care service utilization.
Conclusion: The magnitude of good maternal healthcare utilization is low based on postnatal checkups missed from the continuum of care. Women of lower socioeconomic status and below secondary level of education should be targeted to intensify the awareness of the benefits of maternal healthcare services utilization and planed childbirths to deal with complications that arise from pregnancy and childbirth.[Ethiop. J. Health Dev. 2021;35(4) 309-319]
Key Words: Continuum of Care, Latent classes, Trajectory Analysis, Maternal Healthcare Utilization