alt y He hca ar re : im O r p P e Teshome Getachew et al, Primary Health Care f n o A l c a 2014, 4:4 c n e r s u Primary Health Care: Open Access s o DOI: 10.4172/2167-1079.1000170 J ISSN: 2167-1079 Research Article Open Access Focused Antenatal Care Service Utilization and Associated Factors in Dejen and Aneded Districts, Northwest Ethiopia Teshome Getachew1, Amanuel Alemu Abajobir2* and Mekonnen Aychiluhim3 1USAIDDeliver Project, L10K, Debremarkos, Ethiopia 2Public Health Department, Debremarkos University, Debremarkos, Ethiopia 3GAMBY College of Medical Sciences, Bahirdar, Ethiopia *Corresponding author: Amanuel Alemu Abajobir, Lecturer and Researcher, DMU, RFH, P.O.Box: 269, Debremarkos, Ethiopia, Tel: +251921540059; E-mail: [email protected] Rec date: July 8, 2014, Acc date: Aug 28, 2014; Pub date: Aug 30, 2014 Copyright: © 2014 Abajobir AA et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Focused antenatal care considers every pregnant woman at high risk for developing pregnancy- related complications. Hence, all pregnant women should receive at least four antenatal visits to early identify the complications and intervene accordingly. Therefore, this study attempted to assess focused antenatal care service utilization and associated factors among mothers who gave birth in the last 2 years prior to the study in Dejen and Aneded districts, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted on mothers who gave birth in the last 2 years in 2013. Multistage sampling was used to get the total sample size of 521. Pre-tested structured questionnaires were used to collect the data. The data were entered and cleaned by using Epi info version 6 and exported to SPSS version 16.0 software package for analysis. Results: A total of 509 mothers who have history of antenatal care for their last birth in the last two years were included in the study from which 61 (12.0%, 95%CI: 11.87, 12.13) mothers attended focused antenatal care service. Marital status (single/divorce women) (AOR= 3.44, 95%CI: 1.43, 8.26), travelling more than one hour to obtain antenatal services (AOR=8.21, 95%CI: 1.28, 36.8) and abortion history (AOR= 3.57 and 95%CI: 1.62, 7.86) were significantly associated with focused antenatal care service utilization. Conclusion and recommendations: The majority of pregnant mothers did not attend focused antenatal care during their last pregnancy. Marital status, travel time to health facility, history of abortion and illness, plan of pregnancy and sources of information were identified as factors affecting focused antenatal care service utilization. Provision of focused antenatal care should be used as an opportunity for early detection of pregnancy related complications. Women health development army in the districts should be used to disseminate information regarding FANC for pregnant mothers. Keywords: Focused; Antenatal care; Ethiopia In Ethiopia, the maternal mortality was estimated to be 673 deaths per 100,000 live births and infant mortality rate was 77 per 1,000 live Introduction births, which is among the highest in the world. As emphasized in the 2005 Ethiopian Demographic Health Survey (EDHS), one explanation Antenatal Care (ANC) is an umbrella term used to describe the for poor health outcomes among women in Ethiopia was non-use of medical procedures and care that are carried out during pregnancy. modern health care services. The goal-oriented antenatal care approach was recommended by researchers in 2001 and adopted by the World Health Organization The new model reduces the number of required antenatal visits to (WHO) in 2002. Ethiopia has accepted and adopted Focused four, and provides focused services shown to improve maternal Antenatal Care (FANC) as part of monitoring women's health and outcomes. Focused antenatal care eliminates the traditional risk offering preventive services [1]. assessment and instead emphasizes helping women to maintain normal pregnancies by identifying existing health conditions, Focused antenatal care approach recognizes two key realities: first, detecting emerging complications, promoting health, preparing for a frequent antenatal visits do not necessarily improve pregnancy healthy birth, and educating clients on postpartum care including outcomes and secondly, many women with risk factors may never nutrition, breastfeeding and family planning [3]. develop complications. While ANC interventions, maternal mortality and the death of a woman while pregnant or within 42 days of Focused antenatal care recognizes that every pregnant woman is at termination of pregnancy, remains disturbingly high in sub-Saharan risk for complications, and therefore all women should receive basic Africa [2]. care and monitoring for complications. The provision of quality basic care-safe, simple, cost-effective interventions that all women should receive in turn helps maintain normal pregnancies and can save lives Primary Health Care Volume 4 • Issue 4 • 1000170 ISSN:2167-1079 PHCOA, an open access journal Citation: Getachew T, Abajobir AA, Aychiluhim M (2014) Focused Antenatal Care Service Utilization and Associated Factors in Dejen and Aneded Districts, Northwest Ethiopia. Primary Health Care 4: 170. doi:10.4172/2167-1079.1000170 Page 2 of 8 by preventing complications and facilitating early detection and kebeles and the study participants were selected using computer treatment of complications [4]. generated random numbers. If there was more than one mother within the same household lottery method was used to select the eligible According to EDHS (2011), FANC service coverage in Ethiopia was mother. 19.1%. Despite low utilization of health care services, there is considerable variation across different demographic and socio- economic variables in utilizing FANC [5,6]. Data collection procedures Studies that focused on maternal mortality and morbidity in Data were collected by face-to-face interview using structured and developing countries have repeatedly recommended the need for pre-tested questionnaires. The questionnaires have embodied socio- FANC and availability of trained personnel to attend women during demographic characteristics, obstetric history and service delivery labor and delivery [7]. patterns. Sixteen Health Extension Workers (HEW) collected the data and two supervisors (one BSc. nurse and one environmental health However, in Ethiopia the utilization of FANC is still very low and officer) from the districts health office were assigned to monitor the many of the studies done so far did not target FANC. As a result, this data collection process. study aimed at assessing the utilization and factors affecting FANC among mothers in the study areas. Data quality control Methods The quality of data was assured by proper designing and pre-testing of the questionnaires to ensure validity. The questionnaires were first prepared in English and translated to Amharic (local language). Study design, period and setting Finally, it was translated back to English by another person and A cross-sectional study was conducted among mothers who have training was given for both data collectors and supervisors by the history of ANC for their last birth in the last two years in Dejen and principal investigators. The training included discussion on the Aneded districts, Northwest Ethiopia from 21st July to 30th August objectives of the study, contents of the questionnaires, data collection 2013. Based on 2012 estimation, Dejen and Aneded districts had a techniques and issues of confidentiality of the responses. total population of 113,672 (of which 47.5% were child bearing women Questionnaires were reviewed and checked for completeness by the (15-49 years)) and 98,606 (of which 54.7% were child bearing women supervisors and the principal investigators and the necessary feedbacks (15-49 years)), respectively. Dejen district had 3 urban and 20 rural were offered to data collectors throughout the study. kebeles (smallest administrative units), 5 functional health centers and 21 health posts whereas Aneded comprised of 1 urban and 19 rural Data processing and analysis kebeles and 5 functional health centers and 20 health posts. All the questionnaires were checked visually, coded and entered into EPI info version 6 and were exported to SPSS version 16.0 Source and study population software packages for analysis. Double entry and frequency checks The source populations were all reproductive age women attending were done to control for errors. Univariate, bivariate and multivariable ANC clinic in the last two years in Dejen and Aneded districts; analyses were done. The data were analysed using binary logistic whereas selected reproductive age women attending ANC clinic in the regression to determine the effect of various factors on the outcome last two years in the districts were the study populations. Child bearing variable and to control confounding effect, multiple logistic age women who had ANC visit in the last two years and lived for at regressions was used. The results were presented in tables, figures and least six months in the study area were included and those who were texts using frequencies and summary statistics such as mean, standard severely ill and/or unable to hear from the study were excluded. deviation and per cent to describe the study populations in