Inequalities in the Utilization of Maternal Health Services by Key Indicators in Ethiopia

Abstract

Introduction: Inequalities in health are a major challenge for health policy, because most of them can be considered unfair or unreasonable. The aim of this study was to examine inequality in maternal health service indicators based on selected inequalities dimension. Methods: The Demographic and Health Survey datasets of Ethiopia (2000, 2005 and 2011) were used. Five maternal health service indicators such as four or more antenatal care visits from a skilled professional, at least one antenatal care visit, delivery assistance from a skilled birth attendant, modern contraceptive use by married women and demand family planning satisfied were included in the study. Each of these maternal health services were stratified by economic, education and place of residence. We calculated the ratio and concentration index inequality measure using World Health Organization health equity assessment toolkit (HEAT) software version 1.0.Results: Improvement in maternal health service utilization observed across each survey year by economic, education and place of residence but utilization was uneven. The maternal health services utilization are concentrated in advantage groups (richest quintile, urban and educated secondary & above).  The least equality related to economics, educational levels and residence is observed in the utilization of skilled birth attendants and four or more antenatal care visits. Conclusion: Maternal health services use inequality related to economic, education and residence are observed in all indicators and the utilization are concentrated in advantaged groups. Health inequality related to maternal health service use in terms of wealth quintiles, educational levels and residence need due emphasis to narrow the gap between advantaged and disadvantaged population distribution.

Keywords: Maternal; Health Service; Inequality; Ethiopia