Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey

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Abstract Background: 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, four visits providing essential proof-based mostly interventions square measure needed. Therefore, this study was performed to identify determinants of an Optimal ANC visit and its spatial distribution in Ethiopia. Methods: A total of 8,025 women who had a live birth in the five years preceding the survey were included in this study. The binary response variable considered in this study indicated whether women completed an optimal ANC visit or not from skilled health care providers and coded as 1/0. 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. Results: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 risk areas for an optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: 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 affected by women’s’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give spatial attention regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits. Keywords: Optimal Antenatal Care Visit, Determinant, Spatial distribution, Ethiopia

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