Maternal health, service utilisation and its determinants among women who gave birth in the last 12 months across Afar, Benishangul-Gumuz, Gambella and Somali region, Ethiopia: a cross-sectional study in four developing regional states of Ethiopia

Objectives This study aims to assess maternal health and service utilisation and identify the key determinants across Afar, Benishangul-Gumuz, Gambella and Somali, the four developing regional states (DRS) of Ethiopia. Design A community-based cross-sectional study was conducted from September 2020 to February 2021 using stratified multistage cluster sampling for permanent residents and a random route approach for refugee populations.

Setting The study was conducted at the community level across the DRS of Ethiopia, including Afar, Benishangul-Gumuz, Gambella and Somali regions. Participants A total of 1226 women who gave birth within the last 12 months participated, including 1028 non-refugees and 198 refugees living in temporary settlements.

The mean age of participants was 26.4 years (SD±5.7). Primary and secondary outcome measures The primary outcome was maternal health service utilisation, defined as receiving at least one of the two services, antenatal care (8+ contacts) or postnatal care (staying in a health facility after delivery or visiting a health facility within the first 45 days postpartum and being checked for early postpartum danger signs and taking treatments accordingly).