Abstract
IntroductionInadequate counselling of pregnant women regarding pregnancy danger signs contributes to a delay in deciding to seek care, which causes up to 77% of all maternal deaths in developing countries. However, its spatial variation and region-specific predictors have not been studied in Ethiopia. Hence, the current study aimed to model its predictors using geographically weighted regression analysis.MethodsThe 2019 Ethiopian Mini Demographic and Health Survey data were used. A total weighted sample of 2922 women from 283 clusters was included in the final analysis. The analysis was performed using ArcGIS Pro, STATA V.14.2 and SaTScan V.10.1 software. The spatial variation of inadequate counselling was examined using hotspot analysis. Ordinary least squares regression was used to identify factors for geographical variations. Geographically weighted regression was used to explore the spatial heterogeneity of selected variables to predict inadequate counselling.ResultsSignificant hotspots of inadequate counselling regarding pregnancy danger signs were found in Gambella region, the border between Amhara and Afar regions, Somali region and parts of Oromia region. Antenatal care provided by health extension workers, late first antenatal care initiation and antenatal care follow-up at health centres were spatially varying predictors. The geographically weighted regression model explained about 66% of the variation in the model.ConclusionInadequate counselling service regarding pregnancy danger signs in Ethiopia varies across regions and there exists within country inequality in the service provision and utilisation. Prioritisation and extra efforts should be made by concerned actors for those underprivileged areas and communities (as shown in the maps), and health extension workers, as they are found in the study.
Reference24 articles.
1. Amiruddin H , Ansariadi A , Palutri S . Counseling quality of danger signs pregnancy in work region or rural and urban primary health center district Jeneponto. Proceedings of the International Conference on Healthcare Service Management 2018; Tsukuba Japan, 2018 doi:10.1145/3242789.3242818 Available: https://dl.acm.org/doi/proceedings/10.1145/3242789
2. Central Statistical Agency (CSA) [Ethiopia] and ICF . Ethiopia demographic and health survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF, 2016.
3. Awareness of danger signs and symptoms of pregnancy complication among women in Jordan;Okour;Int J Gynaecol Obstet,2012
4. Shewiyo EJ , Mjemmas MG , Mwalongo FH , et al . Does knowledge of danger signs influence use of maternal health services among rural women? Findings from Babati rural district, northern Tanzania. In Review [Preprint] 2019. doi:10.21203/rs.2.16594/v1
5. The effect of counseling intervention of pregnancy danger signs on cadre knowledge;Latip;Health Notions,2023