Antenatal Care Service Utilization of Pregnant Women Attending Antenatal Care in Public Hospitals During the COVID-19 Pandemic Period

Background: The recent coronavirus disease (COVID-19) pandemic has had a disastrous effect on the health-care delivery system, of mainly pregnancy-related healthcare. In order to fill the information gap in the scientific literature and in response to the limited evidence in the country, this study aims to assess the impact of the COVID-19 pandemic on antenatal care utilization among pregnant women attending public facilities in Northeast Ethiopia. Therefore, the result will be beneficial to design strategies for prioritizing maternal healthcare even with the COVID-19 pandemic period. Methods: A facility-based cross-sectional study was conducted from February 2 to August 30, 2020 among pregnant women attending ANC services at public hospitals in Northeast Ethiopia. Thus, a total of 389 women were included in the study with a simple random sampling technique. The bi-variable and multi-variable logistic regression models were employed to identify factors significantly associated with ANC utilization. Adjusted odds ratio (AOR) with 95% CI was estimated to show the strength of association. Finally, a P-value of <0.05 in the multivariable logistic regression analysis was used to identify predictors of antenatal care utilization. Results: Overall, 114 (29.3%) pregnant women had fully utilized antenatal care services during the pandemic period. Mother age >= 35 years (AOR=11.79, 95% CI=1.18- 117.8), secondary education and above (AOR=4.74, 95% CI=1.04- 21.61), history of stillbirth before recent pregnancy (AOR=0.007, 95% CI=0.001-0.12), interruption and diversion of services due to COVID-19 response (AOR=0.675, 95% CI=0.142-0.742), fear of COVID-19 (AOR=0.13, 95% CI=0.06-0.31), and lack of transport access (AOR=4.15, 95% CI=1.04-16.54) were predictors of full antenatal care service utilization. Conclusion: Three of every ten pregnant women who attended the obstetric outpatient clinics have fully utilized the antenatal care services. Encouraging women's educational status, prioritizing maternal health services during COVID-19, and improving the quality of ANC service should be emphasized more.