Effective coverage and associated factors of antenatal care service among women who attended antenatal care at West Gojjam Zone Public Hospitals, Northwest Ethiopia

Abstract

BACKGROUND: Effective coverage reflects the performance of a health system by integrating need, service utilization, and quality of care into a single measure. In many developing countries, inadequate effective coverage of antenatal care services along with poor quality maternal health services and low levels of awareness about healthcare has contributed to maternal mortality ratios that are 14 times higher than those in developed countries. Despite this significant disparity, there is limited evidence available regarding the effective coverage of antenatal care in Ethiopia. Therefore, this study aimed to assess the effective coverage of antenatal care and associated factors among women who attended antenatal care at West Gojjam Zone Public Hospitals, northwest Ethiopia. METHODS: A facility-based retrospective cross-sectional study design was carried out in West Gojjam public hospitals from June 30 to July 30, 2023. Study participants were selected using a multi-stage simple random sampling technique using patient identification number as a sampling frame. Data were gathered from hospital health information data systems and client charts, entered into Epi data version 4.6, and then exported to SPSS statistical package version 25 for further analysis. Both bi-variable logistic regression and multi-variable logistic regression analyses were carried out. Variables with p-value <0.25 in the bi variable logistic regression were entered into multi-variable logistic regression. Variables having P-values <0.05 in the multi-variable logistic regression were considered as statistically significant predictors of the outcome variable. RESULTS: The effective coverage of antenatal care service was 25.9% (95% CI: 22.6, 29.4%) in the study area. Age of mothers ranged 25-34 (AOR: 0.32; 95% CI; 0.20-0.50), wanted pregnancy (AOR: 1.65; 95% CI; 1.08-2.55), presence of previous obstetric complication (AOR: 6.27; 95% CI; 3.83-10.28) and presence of previous gynecological complication (AOR: 2.08; 95% CI; 1.66-3.77) were statistically significantly associated variables with effective coverage of antenatal care services. CONCLUSION: In this study one out of four mothers received effective coverage of antenatal care in the study area. Age of mothers ranged from 25 to 34, wanted pregnancy, presence of previous obstetric complication and presence of previous gynecological complication were statistical significant predictors of effective coverage of antenatal service. Therefore, boosting effective antenatal care requires targeted interventions based on identified predictors.