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Maternal care in Ethiopia

Study findings show need to address cultural traditions and inequities to improve maternal health care service use.

Maternal mortality is a serious problem faced in developing countries like the nations of Sub-Saharan Africa. These countries account for around two-thirds of the nearly 300,000 preventable deaths during pregnancy and childbirth worldwide each year, with Ethiopia having one of the highest maternal mortality rates despite improvements in recent years.

A new study published in Maternal and Child Health Journal explores changes in health care use and factors related to maternal health care in Ethiopia. The study focuses on the use of antenatal care, skilled birth attendants and postnatal care, and possible influencing factors like age, educational level, household wealth and area of residence. Qiping Fan, doctoral student in the Texas A&M University School of Public Health, and other public health researchers compared 2011 and 2016 data from a national demographic and health survey in Ethiopia to determine how care service use changed and why.

The researchers found that the use of prenatal care and skilled birth attendants increased during the study period; however, the use of postnatal care was lower and decreased during the same span. The study also found that mothers in rural areas were less likely to use postnatal care services and that those with the lowest household wealth were the least likely to seek care after birth. Skilled birth attendant use was also lower in rural areas; however, mothers without a partner were more likely to use skilled birth attendants. The increase in prenatal care service use could be due to efforts by the Ethiopian Federal Ministry of Health to promote those services.

The low and decreased use of postnatal care, especially in rural areas, could be attributed to cultural beliefs and traditional practices like confining mothers and newborns for 40 days after birth. People in rural Ethiopia and lower wealth households also face structural problems like needing to travel long distances to care providers and high costs that must be addressed. The researchers note that family, friends and neighbors could help improve postnatal care use. For example, not having someone to care for other children may keep some mothers from seeking postnatal care, and family and friends could help by assisting with childcare. Emphasizing the importance of postnatal care during prenatal visits could also help increase use of after birth care services.

Future efforts to increase care use should focus on cultural factors and address inequities to improve maternal health care service use.

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