Abstract

OBJECTIVES

Maternal mortality remains unacceptably high in sub-Saharan Africa with 533 maternal deaths per 100 000 live births, accounting for 68% of all maternal deaths worldwide. Most maternal deaths could be prevented by adequate maternal health service use. The study examined the effect of literacy status on maternal health services utilisation among reproductive-age women in Ethiopia.

DESIGN

A cross-sectional study.

SETTINGS

Ethiopia.

PARTICIPANTS

A weighted sample of 3839 reproductive-age women who gave birth in the last 5 years preceding the survey and whose literacy status was measured were included in this study. The survey used a two-stage stratified cluster sampling technique.

PRIMARY AND SECONDARY OUTCOME MEASURES

This study used a dataset from the recent Ethiopia Mini Demographic and Health Surveys. We assessed the maternal health service utilisation among reproductive-age women. Multivariable logistic regression analyses were employed to assess the association between literacy status and maternal healthcare utilisation while controlling for other factors. Adjusted OR with a 95% CI was reported.

RESULTS

About 63.8% of reproductive-age women were illiterate. The prevalence of antenatal care (ANC) 1, ANC 4, skilled birth attendance and postnatal care (PNC) services utilisation was 74.9%, 43.5%, 51.9% and 32.0%, respectively. Literate women had significantly higher ANC 1, ANC 4, skilled birth attendance, and PNC services utilisation than illiterate women (p<0.001). Regional variation, wealth status, age at first birth, birth order and birth intervals were significantly associated with maternal healthcare utilisation among both literate and illiterate women. Similarly, ANC booking timing and utilisation, age of household head and religious affiliation were associated with institutional delivery and PNC utilisation.

CONCLUSION

Literate women had a significantly higher maternal healthcare services utilisation than illiterate, modified by sociodemographic and obstetric-related factors. Hence, wholehearted efforts should be directed towards educating and empowering women.

MeSH

Maternal Health Services, Parturition, Maternal Death, Health Surveys, Demography, Health Services, Literacy

Cited by

• Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey. Front Public Health, 2025
• Factors Influencing Maternal Health Literacy in Postpartum Women. Int J Womens Health, 2025
• Mapping traditional birth attendance in sub-Saharan Africa between 2012 and 2023: analysis of data from demographic and health surveys. AJOG Glob Rep, 2025
• Assessing the joint effects of education, economic status, empowerment, and employment (4Es) disparities on the co-coverage of maternal, newborn and child health care services in sub-Saharan Africa: an application of the intersectionality approach. J Glob Health, 2025