Skip to content
Despite the pro-poor health policies in Ethiopia, the utilisation of maternal, neonatal, and child health services remains a challenge for the country. This paper aims to assess equity in utilisation of a range of maternal and child health services.

Alem Desta Wuneh, a PhD student with the Dagu project, published this paper in the International Journal for Equity in Health.

This study used data on maternal and child health utilisation collected for the ‘Optimizing the Health Extension Program’ from December 2016 to February 2017 in four regions of Ethiopia. The utilisation of four or more antenatal care visits; skilled birth attendance; postnatal care within 2 days after childbirth; immunisation with BCG, polio 3, pentavalent 3, measles and full  immunisation of children aged 12–23 months; and vitamin A supplementation for 6–23 months old children were stratified by wealth quintiles.

Results show that maternal health services utilisation was low and inequitably distributed favouring the better-off women. About 44, 71, and 18% of women from the better-off households had four or more antenatal visits, utilised skilled birth attendance and postnatal care within two days compared to 20, 29, and 8% of women from the poorest households, respectively. Skilled birth attendance was the most inequitably distributed maternal health service. All basic immunisations: BCG, polio 3, pentavalent 3, measles, and full immunisation in children aged 12–23 months and vitamin A supplementation were equitably distributed.

In conclusion the authors note that the utilisation of maternal health services was low, inequitable, and skewed against women from the poorest households. In contrast, preventive child health services were equitably distributed. Efforts to increase utilisation and reinforcement of pro-poor and pro-rural strategies for maternal, newborn and immunisation services in Ethiopia should be strengthened.


Alem Desta Wuneh

Dagu PhD student

Professor Lars Åke Persson

Professor of Public Health Evaluation

Profile picture of Professor Joanna Schellenberg
Professor Joanna Schellenberg

IDEAS Co-Principal Investigator and Professor

Yemisrach Okwaraji

Research Fellow