ABSTRACT
Background: Antenatal care (ANC) reduces maternal and newborn mortalities and makes it easier to find infections early and prevent them from progressing. This study aimed to identify factors affecting ANC utilization in Ethiopia via the count regression model. Methods: The data for the study was drawn from the 2019 Ethiopian Mini Demographic and Health Survey dataset. Count regression models, such as Poisson, Negative Binomial (NB), Zero-Inflated Poisson (ZIP), and Zero-Inflated Negative Binomial (ZINB) models, were used to determine the factors influencing ANC utilization. Results: A total of 3962 women were included in the study. Only about 42% of women used the WHO-recommended number of ANC of a minimum of four visits. The ZIP model was outperforming to fit the data as compared to other count regression models. Rural residence (IRR=0.8832, 95% CI: 0.8264-0.9440), being resident of the Somalia region (IRR=0.4762, 95% CI: 0.3919-0.5785), SNNPR (IRR=0.8716, 95% CI: 0.7913-0.9600), and Gambela Region (IRR=0.7830, 95% CI: 0.7063-0.8680), being Muslim (IRR=0.9384, 95% CI: 0.8876-0.9921) decrease the ANC utilization. Contrarily, Addis Ababa residence (IRR=1.1171, 95% CI: 1.0181-1.2259), primary education (IRR=1.1278, 95% CI: 1.0728-1.1855), secondary and higher education (IRR=1.2357, 95% CI: 1.1550-1.3220), middle wealth index (IRR=1.0855, 95% CI: 1.0095-1.1671) and rich wealth index (IRR=1.0941, 95% CI: 1.0152-1.1790) increase the ANC utilization. Conclusion: The ZIP model best fitted the data compared to others. The study revealed that being poor, rural resident, uneducated, Somalia region resident, SNNPR resident, Gambela region resident, and Muslim were factors associated with lower ANC utilization. Thus, health education is needed to be given for mothers with no education. In addition, building a strong awareness-creation program regarding ANC is required for rural residents so as to improve the level of ANC utilization in Ethiopia.
ABSTRACT
BACKGROUND: World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. EBF has sustainable long-term health benefits for both infants and mothers. Despite its benefits, the practice of EBF in Ethiopia is lower than the internationally recommended one. This study aimed at identifying factors influencing EBF practice among under-6 month infants in Ethiopia. METHODS: This study used data drawn from the 2019 Ethiopian Mini Demographic and Health Survey (2019 EMDHS) data. A multivariable logistic regression model was employed to investigate factors significantly associated with EBF practice among under-6 month infants in Ethiopia. An adjusted odds ratio with 95% confidence interval was used to measure the association of factors with EBF practice. RESULTS: A total of 566 infants under the age of 6 months were included in the study. The prevalence of exclusive breastfeeding practice was 83% (95% CI: 79.70-86%). Urban residences (AOR: 0.40, 95% CI: 0.22-0.73), mothers having secondary education (AOR: 1.54, 95% CI: 1.29-1.84) and higher education (AOR: 3.18, 95% CI: 0.68-15.02), mothers having ANC visits of 1 to 3 times (AOR: 1.52, 95% CI: 1.24-1.88) and ANC visits of 4 and more times (AOR: 4.27, 95% CI: 1.06-17.25), family size of more than 5 (AOR: 0.45, 95% CI: 0.26-0.88), caesarean births (AOR: 0.63, 95% CI: 0.42-0.95), and deliveries at health facilities (AOR: 2.51, 95% CI: 1.12-5.63) were factors significantly associated with EBF practice among under-6 month infants. CONCLUSION: In this study, EBF practice among under-6 month infants was significantly associated with place of residence, maternal educational level, ANC visits, family size, mode of delivery, and place of delivery. Therefore, encouraging ANC visit and promotion of institutional (health facility) delivery are recommended. Furthermore, special attention has to be given to mothers with no or less education to make them better aware of the EBF and its benefits to enhance exclusive breastfeeding practice.
