Improving Maternal Health Service Use Among Underserved Pregnant Women

Evaluation of a Quasi-Experimental Study in Rural Ethiopia

Datos Bibliográficos

ID21616581
AutoresBee-Ah Kang (0000-0002-1124-2481, Behavior and Society, autor de correspondencia), R N Rimal (0000-0003-1413-9305, Behavior and Society), Yihunie Lakew (0000-0002-1520-0844, Johns Hopkins Bloomberg School of Public Health), Habtamu Tamene Temesgen (0009-0004-3681-8338, Johns Hopkins Bloomberg School of Public Health)
Año2026
Páginas1-12
Fecha de publicación2026-06-24
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Communication (JOURNAL)
Identificadores de la revistaISSN: 1041-0236 • E-ISSN: 1532-7027
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10410236.2026.2692533
PMID42340365
OpenAlexW7165731484
IdiomaEN
Referencias citadas50

The World Health Organization recommends that pregnant women attend antenatal care (ANC) regularly throughout pregnancy and deliver in a health facility. While prior interventions have sought to address social barriers to maternal health service utilization, the specific social mechanisms through which these interventions exert influence remain unclear. This study examined changes in key social factors following the intervention and their associations with maternal health service utilization over time in a quasi-experimental study in Ethiopia. Pregnant women facing intersecting vulnerabilities were identified and enrolled in two intervention and two control districts and surveyed at pre- and post-intervention. The intervention included educational audio programs, print materials, and home visits by community health volunteers. Results showed that improvements in injunctive norms, couple communication, and social support were significantly greater among women in the intervention group than in the control group. Overall, women who received the intervention were more likely to use ANC and delivery services at health facilities. Regression analyses showed that improvements in descriptive and injunctive norms, as well as couple communication, predicted ANC use. Improvements in descriptive norms were associated with health facility-based delivery. Institutional delivery appeared less responsive to social influence alone, indicating that structural barriers require concurrent attention. Findings also highlight the central role of social norms in shaping maternal health behaviors, alongside couple communication. Social norms-based strategies, such as using social proof messaging and engaging influential referents, may help catalyze behavioral shifts among pregnant women in low-resource settings

Descriptive statistics · Pregnancy · Prenatal care · Psychological intervention · Public health · Social determinants of health · Social norms approach · Social support · Child Nutrition and Water Access · Global Maternal and Child Health · Maternal Mental Health During Pregnancy and Postpartum