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dc.date.accessioned2023-03-14T13:22:39Z
dc.date.available2023-03-14T13:22:39Z
dc.date.issued2023
dc.identifier.isbn978-82-348-0155-6
dc.identifier.urihttp://hdl.handle.net/10852/101434
dc.description.abstractThe actions we take to prevent ourselves from becoming ill are influenced by social determinants of health. The same is true for a pregnant woman who wants to make sure that her unborn child and herself are healthy during the course of the pregnancy and childbirth, and beyond. Whether she attends antenatal care and/or delivers at a health facility or not is dependent on a host of determinants at the individual and community level, and within a socioeconomic and political context. Available studies in Ethiopia have not sufficiently explored the impact of local social determinants of maternal health care utilization. The thesis aims to study the impact of various social determinants and intimate partner violence on the utilization of maternal healthcare services. It also explores the characteristics of women identified as a positive deviant in relation to use of maternal health care services. Existing data from almost 50 000 responses from the Ethiopian Demographic and health Surveys in 2005, 2011 and 2016 was used. A large number of social determinants were analyzed. The results showed that the country has witnessed an encouraging improvement in the ANC coverage (at least one visit) in the last decade from 28.5% in 2005 to 62.8% in 2016. On the other hand, the receipt of adequate ANC by the women is a real challenge – only 32% of the Ethiopian women met the current Ethiopian policy recommendation of four ANC visits for the index pregnancy in 2016. In addition, health facility deliveries is staggering low in the country. Only 26% of the women who had a live birth in preceding five years of the 2016 survey were delivered in health facilities although this represented an improvement from 5% in 2005. Moreover, significant disparities in ANC and health facility delivery uptake between urban and rural areas, across regions and by socio-economic status were detected. We also identified that there are several risk and protective factors with a significant impact on the utilization of maternal healthcare services. Lower maternal age, low socioeconomic status, lack of education, living rural areas and pastoralist region, perceived challenge to reach health facility and partner violence were shown to be risk factors, as higher socioeconomic status, partner's education, woman's employment status, having employed partner’s, media exposure, women empowerment and living in urban area were a protective factor. Overall, the findings of the study provide additional insights for addressing the identified risk and protective factors is essential in order to better understand the social process related to maternal healthcare services utilization and design appropriate context specific strategies and policies if Ethiopia desires to progress towards the SDGs set for maternal health.en_US
dc.language.isoenen_US
dc.relation.haspartPaper I. Ousman SK, Mdala I, Thorsen VC, Sundby J and Magnus JH (2019) Social Determinants of Antenatal Care Service Use in Ethiopia: Changes Over a 15-Year Span. Front. Public Health 7:161. doi: 10.3389/fpubh.2019.00161. The paper is included in the thesis. Also available at: https://doi.org/10.3389/fpubh.2019.00161
dc.relation.haspartPaper II. Ousman SK, Gebremariam MK, Sundby J, Magnus JH (2022) Maternal exposure to intimate partner violence and uptake of maternal healthcare services in Ethiopia: Evidence from a national survey. PLoS ONE 17(8): e0273146. doi: 10.1371/journal.pone.0273146. The paper is included in the thesis. Also available at: https://doi.org/10.1371/journal.pone.0273146
dc.relation.haspartPaper III. Seman K. Ousman, Jeanette H. Magnus, Johanne Sundby and Mekdes K. Gebremariam (2020) Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach. Int. J. Environ. Res. Public Health 2020, 17, 1712; doi: 10.3390/ijerph17051712. The paper is included in the thesis. Also available at: https://doi.org/10.3390/ijerph17051712
dc.relation.urihttps://doi.org/10.3389/fpubh.2019.00161
dc.relation.urihttps://doi.org/10.1371/journal.pone.0273146
dc.relation.urihttps://doi.org/10.3390/ijerph17051712
dc.titleSocial Determinants and Maternal Health Care Utilization in Ethiopia: Risk and Protective Factorsen_US
dc.typeDoctoral thesisen_US
dc.creator.authorOusman, Seman Kedir
dc.type.documentDoktoravhandlingen_US


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