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Inequities in maternal health services utilization in Ethiopia 2000-2016: magnitude, trends, and determinants
Authors: Emebet Gebre, Alemayehu Worku, and Fawole Bukola
Source: Reproductive Health, 15(1): 119; DOI: 10.1186/s12978-018-0556-x
Topic(s): Health care utilization
Health equity
Maternal health
Country: Africa
Published: JUL 2018
Abstract: BACKGROUND: Inequities in maternal health services utilization constitute a major challenge in maternal mortality reduction in Ethiopia. We sought to assess magnitude, trends, and determinants of inequities in maternal health services utilization in Ethiopia from 2000 to 2016. METHODS: The study utilized data from the 2000 and 2016 Ethiopia Demographic and Health Surveys, which were done based on a cross sectional survey design. The wealth-related inequities were assessed by concentration curve and horizontal inequity indices. Trends in inequities were assessed by comparing the concentration indices of maternal health services utilization variables between the 2000 and 2016 surveys using Wagstaff two groups concentration indices comparison method. Finally, the inequities were decomposed into its contributing factors using Wagstaff method of analysis. RESULTS: Wealth-related inequities were significantly high in 2016: with horizontal inequities indices and residual regression error of antenatal care, skilled birth attendance, and postnatal care service utilization (-?0.09 and?-?0.01), (-?0.06 and 0.01), and (-?0.11 and 0.0001), respectively. These indices increased significantly in 2016 when it is compared with the 2000 indices' with the respective concentration indices difference of -?0.05, 0.05, and?-?0.07. The related all p-values were?