The Association between Womens Perception of Community Support for and Utilization of Maternity Healthcare Services in Ethiopia

Ethiopia has one of the highest maternal mortality ratios in sub-Saharan Africa. Many factors contribute, including limited access to and use of maternity care services. Community support plays an important role in influencing womens utilization of such services. The objective of this study was to analyze the association between womens perception of community support and their utilization of maternity healthcare services in Ethiopia while exploring how this association varies by urban and rural residence. Longitudinal data from the Performance Monitoring in Action Ethiopia was used. We excluded women who were postpartum at baseline, did not complete the six-week follow-up survey, and did not deliver a live birth. The total analytic sample for this study was 1,924. We used logistic regression to analyze the relationship between a womans perception of community support for the relevant component and the service utilization. Then, we included an interaction term between community perceptions and residence for each model. The proportion of women with four or more antenatal care visits, who gave birth in a health facility, and had postnatal care visits within 2 days postpartum are 49%, 52%, and 41%, respectively. Womens access to comprehensive maternity care was 25%. Women who perceived their communities as "fully supportive" of comprehensive maternity care were about twice as likely to receive such care compared to women who perceived that the community was not fully supportive of comprehensive maternity care (aOR: 1.89, 95% CI: 1.49-2.38). Regarding the full continuum of care, urban women who perceive full support were significantly more likely to receive all components of care. Perceived community support is an important predictor of womens utilization of maternal care in Ethiopia. These findings highlight a key factor influencing care-seeking behavior and variation between urban and rural residence, contributing to ongoing disparities in healthcare access.