Receiving quality antenatal care service increases the chance of maternal use of skilled birth attendants in Ethiopia: Using a longitudinal panel survey

Background: Evidence has suggested that maternal use of skilled birth attendant is the most important factor to reduce maternal mortality because of more than three-fourths of maternal deaths occur during child delivery or within 24 hours after delivery due to hemorrhage, hypertension, ruptured uterus and sepsis. In Ethiopia, more than 42% of pregnant women with 4+ antenatal care (ANC) visit did not deliver by skilled birth attendant. The factors for women not using skilled birth attendant after any ANC visit is not well-studied yet. Therefore, the aim of this study was to assess effect of quality antenatal care service on maternal use of skilled birth attendant after any antenatal care visit. Methods: This study was initiated using performance monitoring for action Ethiopia longitudinal panel survey datasets. A total of 1,511 postnatal women were included in the analysis. Generalized estimating equation Poisson regression model was used to assess the effect of quality ANC service on maternal use of skilled birth attendant by accounting the clustering nature of the data using Stata vers.16 software. Results: This study showed that about 54% of women used skilled birth attendant during the current baby delivery (rate = 53.6%, 95% UI = 51–56%). Nearly, 39% of the women received quality (more than 75th percentile) ANC service (rate = 39.05%, 95% UI = 36–42%). The highest and the lowest antenatal care service the women received, respectively, were blood pressure measure (91.9%) and syphilis test (12.4%). Women who received better quality ANC service were 20% higher more likely to use skilled birth attendant compared to women who received low quality ANC service (adjusted IRR = 1.20, 95% UI = 1.11, 1.31). Conclusion: Maternal use of skilled birth attendant can be improved by providing quality ANC service during subsequent ANC visits. Improving ANC service delivery may encourage or positively reinforce women’s and partner’s decision to use skilled birth attendant.