Abstract:
Background: Antenatal care (ANC) is one of the components of care to be provided to pregnant women. In
Ethiopia, characterizing the spatial distribution of antenatal care utilization is essential to prioritize risk areas
where ANC is needed and facilitate interventions. Therefore, this spatial analysis was performed to assess the
spatial distribution of ANC utilization between 2000 and 2011 and to identify factors associated with ANC
utilization in Ethiopia.
Methods: A total of 23,179 women who had a live birth in the five years preceding the surveys were
included in the study. The spatial data were created in ArcGIS10.1 for each study clusters. The Bernoulli
model was used by applying Kulldorff methods using the SaTScan™ software to analyze the purely spatial
clusters of ANC utilization. Multiple logistic regression analysis was used to identify predictors affecting ANC
utilization.
Results: ANC utilization had spatial variations across the country. Spatial scan statistics identified 49 high
performing clusters (LLR = 111.92, P < 0.001) in 2000, 51 (LLR = 114.49, P < 0.001) in 2005 and, 86 (LLR = 121.53,
P < 0.001) in 2011. ANC utilization was higher among mothers; with richest wealth quintiles, lowest number of
birth order, who are living in urban areas, younger and educated.
Conclusion: These results provide further insight into differences in ANC utilization in the country and
highlight high and modest performing clusters. This could enable efficient and timely spatial targeting
to improve ANC service up take in Ethiopia
