Rural-urban disparities in full antenatal care utilization among women in Ethiopia: A further analysis of Mini-EDHS, 2019

Background Full antenatal care utilization is a key intervention that creates the opportunity to provide all the necessary health services during pregnancy that aims to reduce maternal and newborn morbidity and mortality. However, there is still a gap in utilizing this service between rural and urban women. So, this study aimed to identify the sources of variations in full antenatal care utilization between the rural and urban areas of Ethiopia. Methods The study used the data on a nationwide representative sample of the Mini- Demographic and Health Survey (DHS) of Ethiopia. The data were collected from March 21, 2019, to June 28, 2019, in all regions of Ethiopia. Two stage cluster sampling techniques were used to select the study participants. This study included about 3,927 (weighted samples) of women aged from 15 to 49 years. A multivariate decomposition analysis technique was performed to observe the rural-urban disparities in full antenatal care utilization explained by residence difference in components of endowments and coefficients. Results The prevalence of full antenatal care utilization was 43.25% (95% CI: 41.7%, 44.8%). The difference in the prevalence of full antenatal care utilization between rural and urban women was (rural prevalence was 27.73%, while in urban areas it was 15.52%). These results showed a statistically significant full antenatal care utilization gap in rural urban resident women (-0.21807, 95% CI:(-0.27397, -0.16217)). The majority of the gap was explained by the covariate distribution, which accounted for 76.84%, and the rest, 23.16%, was due to the effect of covariate differences. Educational status, wealth status, religion, region, birth order, and parity differences between urban and rural women explain most of the full antenatal care utilization disparities. Conclusion and recommendations There is a significant full antenatal care utilization disparity between rural and urban women in Ethiopia. This variation in the rural-urban full antenatal care utilization was explained by differences in characteristics (endowment). So to decrease this gap, emphasis should be given to resource distribution targeting rural households, improvement of maternal education and creating a platform to access information about the service and its relevance.