PASTORALISM AND ANTENATAL CARE SERVICE UTILIZATION IN AFAR, ETHIOPIA, 2015. A COMMUNITY BASED CROSS-SECTIONAL STUDY

Nejimu Biza^1* (BSc, MSC, PhD Candidate), Hussein Mohammed² (MPH),

1-    College of Health Sciences, Samara University , Samara, Afar, Ethiopia

2- Afar Regional Health Bureau, Afar, Semera, Ethiopia

Abstract

Background: Maternal health services are particularly inadequate and poorly equipped, being scarce, inaccessible, and inappropriate to the pastoralist way of life. Effective antenatal care (ANC) use has been shown to influence women’s use of maternal health services, probably the most effective intervention in reducing maternal mortality in the developing world. Despite many studies done on ANC service utilization among agrarian women, the studies done on pastoralist women are almost negligible. Therefore; this study intended to assess utilization and associated factors towards ANC service use in pastoralist mothers of Afar region, Ethiopia.

Methods: A community cross-sectional study was carried out from 5^th January to 5^th February, 2015. The data was collected by interviews through a questionnaire. Statistical analyses were done to describe pertinent findings.

Result: a total of 788 women, 42.4% (334) made at least one antenatal care visit, while 19.5% (65) had adequately utilized antenatal care (i.e., made four or more antenatal care visits). Only 9.7% of women visited an antenatal care center during the first trimester (12 weeks). Educational status of the mother had a significant association with ANC service use. Mothers who attended college/university were five times more likely to utilize ANC service than those mothers who are illiterate. ANC utilization in peri-urban area was two times more than ANC utilization in rural areas with CI of (1.37, 3.59). Multivariate analyses, being pastoralist by way of life (AOR=2.23, 95% CI:  1.38, 3.60), possessing radio/TV (AOR=3.13, 95% CI: 2.20, 4.46), were positively associated with ANC service utilization.

Conclusion: In this study only 20% of the respondents were able to fulfill WHO recommendation of minimum four ANC visits strategy. Pastoralist lifestyles, access and socio-cultural barriers are identified to affect proper utilization of ANC services. Increasing service coverage and promotion of available services in the community, accessible health services, transportation and improving information, education and communication on ANC services must be intensified to reach women in pastoralist communities of the country. Rigorous efforts are needed to reach disadvantaged groups, so as to overcome health inequities between agrarian and disadvantaged pastoralist women.

Key words: Pastoralism, Antenatal care utilization, Afar Region, Ethiopia

*Presenter, PI of the research, PhD fellow at Mekelle University, College of Health Sciences, School of Public health, email nejim76@gmail.com, cell phone 09 10 04 68 21