Abstract:
Background: Although there are many initiatives to improve maternal health services use, utilization of health facility
delivery and postnatal care services is low in Ethiopia. Current evidence at global level showed that antenatal care
increases delivery and postnatal care services use. But previous studies in Ethiopia indicate contrasting results.
Therefore, this meta-analysis was done to identify the effect of antenatal care on institutional delivery and postnatal
care services use in Ethiopia.
Methods: Studies were searched from databases using keywords like place of birth, institutional delivery, and delivery
by a skilled attendant, health facility delivery, delivery care, antenatal care, prenatal care and postnatal care and Ethiopia
as search terms. The Joanna Briggs Critical Appraisal Tools and the Preferred Reporting Items for Systematic Review and
Meta-Analyses were used for quality assessment and data extraction. Data analysis was done using STATA 14.
Heterogeneity and publication bias were assessed using I
2
test statistic and Egger’s test of significance. Forest
plots were used to present the odds ratio (OR) with 95% confidence interval (CI).
Result: A total of 40 articles with a total sample size of 26,350 were included for this review and meta-analysis.
Mothers who had attended one or more antenatal care visits were more likely (OR = 4.07: 95% CI 2.75, 6.02) to deliver
at health institutions compared to mothers who did not attend antenatal care. Similarly, mothers who reported
antenatal care use were about four times more likely to attend postnatal care service (OR 4.11, 95% CI: 3.32, 5.09).
Conclusion: Women who attended antenatal care are more likely to deliver in health institutions and attend postnatal
care. Therefore, the Ethiopian government and other stakeholders should design interventions that can increase
antenatal care uptake since it has a multiplicative effect on health facility delivery and postnatal care services use.
Further qualitative research is recommended to identify why the huge gap exists between antenatal care and
institutional delivery and postnatal care services use in Ethiopia.
Keywords: Antenatal care, Postnatal care, Institutional delivery, Ethiopia, Meta-analysis
