{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T05:57:34Z","timestamp":1765605454059,"version":"3.48.0"},"reference-count":43,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007941","name":"Addis Ababa University","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100007941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,10,16]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The use of maternal health services is an important indicator of maternal health and socioeconomic development. Evidence on individual-level and community-level determinants of use of maternal health services in Benishangul Gumuz Region was not well known so far. Hence, this study fills this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective follow-up study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study was conducted from March 2020 to January 2021 in Northwest Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2198 pregnant women participated in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>A multistage random sampling technique was used to select study subjects. Data were collected via face-to-face interviews using pretested semistructured questionnaires. Collected data were coded, cleaned and analysed using Stata software. Multilevel regression models were applied to determine individual-level and community-level factors of use of maternal health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study found that the proportions of women who visited recommended antenatal care (ANC), received skilled delivery care and postnatal care (PNC) were 66.1%, 58.3% and 58.6%, respectively. Being rural (adjusted OR (AOR)=3.82, 95%\u2009CI 1.35 to 10.78), having information on maternal health services (AOR=2.13, 95%\u2009CI 1.21 to 3.75), with a history of pregnancy-related problems (AOR=1.83, 95%\u2009CI 1.15 to 2.92) and women with decision-making power (AOR=1.74, 95%\u2009CI 1.14 to 2.68) were more likely to attend fourth ANC visits. Similarly, women who attended tertiary school (AOR=4.12, 95%\u2009CI 1.49 to 11.33) and who initiated the first ANC visit within 4\u20136 months of pregnancy (AOR=0.66, 95%\u2009CI 0.45 to 0.96) were determinants of skilled delivery care. Finally, women whose partners attended tertiary education (AOR=3.67, 95%\u2009CI 1.40 to 9.58), women with decision-making power (AOR=1.8, 95%\u2009CI 1.09 to 2.97), women who attended the fourth ANC visit (AOR=10.8, 95%\u2009CI 6.79 to 17.2), women received iron\u2013folic acid during pregnancy (AOR=1.96, 95%\u2009CI 1.11 to 3.49) and women who received skilled delivery care (AOR=1.63, 95%\u2009CI 1.1 to 2.42) were more likely to get PNC services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The proportion of women who attended ANC, received skilled delivery services and PNCs was low. Different individual-level and community-level factors that influenced the use of these services were discovered. Therefore, community-based interventions should target those identified factors to improve maternal health services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-061293","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T10:41:44Z","timestamp":1667990504000},"page":"e061293","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Individual-level and community-level determinants of use of maternal health services in Northwest Ethiopia: a prospective follow-up study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4298-7061","authenticated-orcid":false,"given":"Muluwas Amentie","family":"Zelka","sequence":"first","affiliation":[{"name":"Department of Reproductive Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"},{"name":"Department of Public Health, College of Health Sciences, Assosa University, Asosa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alemayehu Worku","family":"Yalew","sequence":"additional","affiliation":[{"name":"Department of Biostatics and Epidemiology, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gurmesa Tura","family":"Debelew","sequence":"additional","affiliation":[{"name":"Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"2025121221540564000_12.11.e061293.1","unstructured":"Central Statistical Agency (CSA) . 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