Decomposition analysis of Antenatal care utilization inequities among underprivileged communities in southern Ethiopia

Background: Health equity has emerged as a global issue in the post-2015 Sustainable Development Goals, and Ethiopia is no exception. Despite positive improvements, inequities in maternal health service utilization among demographic groups continue to be one of Ethiopia's significant challenges. This study focuses on antenatal care service discrimination among a local underprivileged group of women known as the "Golden Hands" community in Ethiopia's Kembata Tembaro Zone. The subgroup community consists of underprivileged women “Golden-hands," formerly known as "Fuga," who face discrimination in all aspects of life owing to their living conditions and ethnic background. Methods A community-based comparative cross-sectional study was conducted in the Kembata-Tembaro zone of Southern Ethiopia. Double population proportion sample size estimation method was used and a total of 1,210 eligible participants were included in the study, out of which 440 of were Golden-Hands community members. Stratified random sampling was used to choose the samples. The concentration curve and index, as well as multivariable decomposition analysis, were used to examine inequality. Result Discrimination accounted for 60.23 percent of the decreased ANC service use by the Golden Hand community and Endowment accounts for just 39.47 percent of the reduced ANC service. The rate of ANC service is 3.64 times greater in women in the top quintile than in those in the lowest. increasing in age, urban residence, and wealth index were the most important independent factors with statistically significant contributions to discriminated difference. Conclusion High disparity in ANC service was observed in the study and, residency and wealth index contribute the highest proportion to the inequity. Therefore, marginalized groups in society people should get higher attention by policymakers and other organization.