PDF(Pubmed)
Abstract：
BACKGROUND: Antenatal care (ANC) is a principal component of safe motherhood and reproductive health strategies across the continuum of care. Although the coverage of antenatal care visits has increased in Ethiopia, there needs to be more evidence of effective coverage of antenatal care. The \'effective coverage\' concept can pinpoint where action is required to improve high-quality coverage in Ethiopia. Effective coverage indicates a health system\'s performance by incorporating need, utilization, and quality into a single measurement. The concept includes the number of contacts, facility readiness, interventions received, and components of services received. This study aimed to measure effective antenatal care coverage in Ethiopia.
METHODS: A two-stage cluster sampling method was used and included 2714 women aged 15-49 years and 462 health facilities from six Ethiopian regions from October 2019 to January 2020. The effective coverage cascade was analyzed among the targeted women by computing the proportion who received four or more antenatal care visits where the necessary inputs were available, received iron-folate supplementation and two doses of tetanus vaccination according to process quality components of antenatal care services.
RESULTS: Of all women, 40% (95%CI; 38, 43) had four or more visits, ranging from 3% in Afar to 74% in Addis Ababa. The overall mean health facility readiness score of the facilities serving these women was 70%, the vaccination and iron-folate supplementation coverage was 26%, and the ANC process quality was 64%. As reported by women, the least score was given to the quality component of discussing birth preparedness and complication readiness with providers. In the effective coverage cascade, the input-adjusted, intervention-adjusted, and quality-adjusted antenatal coverage estimates were 28%, 18%, and 12%, respectively.
CONCLUSIONS: The overall effective ANC coverage was low, primarily due to a considerable drop in the proportion of women who completed four or more ANC visits. Improving quality of services is crucial to increase ANC up take and completion of the recommended visits along with interventions increasing women\'s awareness.
METHODS: A two-stage cluster sampling method was used and included 2714 women aged 15-49 years and 462 health facilities from six Ethiopian regions from October 2019 to January 2020. The effective coverage cascade was analyzed among the targeted women by computing the proportion who received four or more antenatal care visits where the necessary inputs were available, received iron-folate supplementation and two doses of tetanus vaccination according to process quality components of antenatal care services.
RESULTS: Of all women, 40% (95%CI; 38, 43) had four or more visits, ranging from 3% in Afar to 74% in Addis Ababa. The overall mean health facility readiness score of the facilities serving these women was 70%, the vaccination and iron-folate supplementation coverage was 26%, and the ANC process quality was 64%. As reported by women, the least score was given to the quality component of discussing birth preparedness and complication readiness with providers. In the effective coverage cascade, the input-adjusted, intervention-adjusted, and quality-adjusted antenatal coverage estimates were 28%, 18%, and 12%, respectively.
CONCLUSIONS: The overall effective ANC coverage was low, primarily due to a considerable drop in the proportion of women who completed four or more ANC visits. Improving quality of services is crucial to increase ANC up take and completion of the recommended visits along with interventions increasing women\'s awareness.
摘要：
背景：产前护理（ANC）是整个护理过程中安全孕产和生殖健康策略的主要组成部分。尽管埃塞俄比亚的产前检查覆盖面有所增加，需要有更多证据证明产前护理的有效覆盖。“有效覆盖”概念可以确定需要采取哪些行动来改善埃塞俄比亚的高质量覆盖。有效覆盖率通过结合需求来表明卫生系统的绩效，利用率，和质量到一个单一的测量。该概念包括联系人的数量，设施就绪,收到的干预措施，以及收到的服务的组成部分。这项研究旨在衡量埃塞俄比亚有效的产前护理覆盖率。
方法：采用两阶段整群抽样方法，从2019年10月至2020年1月，纳入了来自六个埃塞俄比亚地区的2714名15-49岁女性和462个医疗机构。通过计算在有必要投入的情况下接受四次或更多次产前检查的比例，分析了目标妇女的有效覆盖级联，根据产前护理服务的过程质量组成部分，接受叶酸铁补充剂和两剂破伤风疫苗接种。
结果：在所有女性中，40%(95CI；38，43)有四次或更多的访问，从阿法尔的3%到亚的斯亚贝巴的74%不等。为这些妇女服务的机构的总体平均医疗机构准备情况评分为70％，疫苗接种和补充叶酸铁的覆盖率为26%，ANC工艺质量为64%。据女性报告，与提供者讨论分娩准备和并发症准备情况的质量部分得分最低.在有效覆盖级联中，输入调整后，干预调整，经质量调整的产前覆盖率估计为28%，18%,12%,分别。
结论：总体有效ANC覆盖率较低，主要是由于完成四次或更多ANC访问的妇女比例大幅下降。提高服务质量对于增加ANC接受和完成建议的访问以及提高妇女意识的干预措施至关重要。
方法：采用两阶段整群抽样方法，从2019年10月至2020年1月，纳入了来自六个埃塞俄比亚地区的2714名15-49岁女性和462个医疗机构。通过计算在有必要投入的情况下接受四次或更多次产前检查的比例，分析了目标妇女的有效覆盖级联，根据产前护理服务的过程质量组成部分，接受叶酸铁补充剂和两剂破伤风疫苗接种。
结果：在所有女性中，40%(95CI；38，43)有四次或更多的访问，从阿法尔的3%到亚的斯亚贝巴的74%不等。为这些妇女服务的机构的总体平均医疗机构准备情况评分为70％，疫苗接种和补充叶酸铁的覆盖率为26%，ANC工艺质量为64%。据女性报告，与提供者讨论分娩准备和并发症准备情况的质量部分得分最低.在有效覆盖级联中，输入调整后，干预调整，经质量调整的产前覆盖率估计为28%，18%,12%,分别。
结论：总体有效ANC覆盖率较低，主要是由于完成四次或更多ANC访问的妇女比例大幅下降。提高服务质量对于增加ANC接受和完成建议的访问以及提高妇女意识的干预措施至关重要。
