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Open Access Highly Accessed Research article

Determinants of maternal health care utilization in Holeta town, central Ethiopia

Kidist Birmeta1*, Yohannes Dibaba2 and Desalegn Woldeyohannes3

Author Affiliations

1 College of Development Studies, Center for Population Studies, Addis Ababa University, Addis Ababa, Ethiopia

2 Department of Population and Family Health, College of Public Health & Medical Sciences, Jimma University, Jimma, Ethiopia

3 Department of Public Health, School of Medicine and Health Sciences, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia

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BMC Health Services Research 2013, 13:256  doi:10.1186/1472-6963-13-256

Published: 3 July 2013



In developing countries a large number of women are dying due to factors related to pregnancy and child birth. Implementing and assuring utilization of maternal health care services is potentially one of the most effective health interventions for preventing maternal morbidity and mortality. However, in Ethiopia the utilization of maternal health care is low.


A cross-sectional study was conducted from January 20 to February 20, 2012 in Holeta town, central Ethiopia, to assess the determinants of maternal health care utilization among women who had given birth in the past three years prior to the survey. Structured questionnaire and focus group discussion guides were used for data collection. Data were collected from a sample of 422 women in the town. Descriptive, bivariate and multivariate logistic regression analyses were conducted. Statistical tests were done at a level of significance of p < 0.05.


The study revealed that 87% of the women had at least one antenatal visit during their last pregnancy. Among the antenatal service users, 33.7% had less than four antenatal visits. More than half of the antenatal care (ANC) attendants made their first visit during their second and third trimester of pregnancy although WHO recommended ANC should be started at the first trimester of the pregnancy. There was a significant association (P<0.05) between ANC attendance and some demographic, socio-economic and health related factors (age at last birth, literacy status of women, average monthly family income, media exposure, attitude towards pregnancy, knowledge on danger signs of pregnancy and presence of husband approval on ANC). The study also revealed that about 61.6% of the women had given birth in the health institutions. Parity, literacy status of women, average monthly family income, media exposure, decision where to give birth, perception of distance to health institutions (HI) and ANC attendance were found to be significantly associated (P<0.05) with delivery care (DC) attendance.


The utilization of ANC and DC service is inadequate in the town. The utilization of ANC and DC were influenced by demographic, socio-economic and health related factors. Improving the status of women by expanding educational opportunities, strengthening promotion of antenatal and delivery care by enhancing community awareness about the importance of ANC and DC are recommended.

Antenatal care; Delivery care; Holeta town; Ethiopia