Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required.. Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia. This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables. This study revealed that rural residence (AOR = 0.59, 95%CI: 0.45–0.77),male partners educational status [secondary school (AOR = 1.33, 95%CI: 1.05–1.67)], distance to the health institutions [not a big problem (AOR = 1.21, 95%CI: 1.04–1.39)], community-level literacy (AOR = 1.07, 95%CI: 1.03–1.12), and community level service utilization (AOR = 2.67,95%CI:2.21–3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits.

中文翻译：

---

埃塞俄比亚孕妇最佳ANC访问的空间分布和决定因素：2016年埃塞俄比亚人口健康调查的进一步分析

产前保健（ANC）对于改善孕产妇和新生儿的健康状况至关重要。非洲有超过三分之二的孕妇至少有一次ANC接触，因此非洲的产前保健覆盖率正在提高。但是，为了实现ANC保证为母亲和婴儿提供的全部救生潜力，至少需要进行四次探视，以提供基于证据的基本干预措施。因此，本研究旨在确定ANC最佳探视及其空间分布的决定因素。在埃塞俄比亚。这项研究是对2016年埃塞俄比亚人口与健康调查（EDHS）的辅助数据分析。这项研究包括总共8025名在调查前的五年内活产的妇女。使用STATA 14软件和ArcGIS10.7软件进行分析。拟合了广义估计方程（GEE）模型，以识别与最佳ANC访问相关的因素。计算95％CI的原始和调整后的优势比，以评估解释变量和结果变量之间的关联强度。这项研究表明，农村居民（AOR = 0.59，95％CI：0.45-0.77），男性伴侣的教育状况[中学（AOR = 1.33，95％CI：1.05-1.67）]，与卫生机构的距离[不是大问题（AOR = 1.21，95％CI：1.04–1.39）]，社区级扫盲（AOR = 1.07，95％CI：1.03–1.12）和社区级服务利用率（AOR = 2.67,95％CI：2.21） –3.24）与最佳ANC访问次数显着相关。根据空间分析结果，在亚的斯亚贝巴，提格雷，哈拉里和Dire Dawa地区观察到了最佳ANC访问，而没有最佳ANC访问的地区是阿法尔，阿姆哈拉，Oromia Benishangul，SNNP和索马里地区。居住在该国外围地区和农村地区的男性伴侣受教育程度较低，与卫生机构的距离也很有限，这些因素阻碍了探视活动的开展。在这项研究中，社区一级的识字率和社区一级的服务使用也影响了妇女的非国大国民使用率，这意味着应考虑采用社区一级的干预措施来提高产前护理的利用率和更好的健康结果。政府应特别注意ANC最佳访问率较低的地区，例如Afar，Amhara，Oromia，Benishangul，SNNP和索马里。男性伴侣的受教育程度较低以及与卫生机构的距离遥远，是探视次数不足的因素。在这项研究中，社区一级的识字率和社区一级的服务使用也影响了妇女的非国大国民使用率，这意味着应考虑采用社区一级的干预措施来提高产前护理的利用率和更好的健康结果。政府应特别注意ANC最佳访问率较低的地区，例如Afar，Amhara，Oromia，Benishangul，SNNP和索马里。男性伴侣的受教育程度较低以及与卫生机构的距离遥远，是探视次数不足的因素。在这项研究中，社区一级的识字率和社区一级的服务使用也影响了妇女的非国大国民使用率，这意味着应考虑采用社区一级的干预措施来提高产前护理的利用率和更好的健康结果。政府应特别注意ANC最佳访问率较低的地区，例如Afar，Amhara，Oromia，Benishangul，SNNP和索马里。