The impact of antenatal care on child mortality in Ethiopia: a difference-in-differences analysis

Abstract Background This article examines the impact of antenatal care on child health outcome. We specifically investigated if women visits to antenatal care services has a positive effect in the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14-49 years who have at least one antenatal care visit before delivery (treatment group) or had no antenatal care visit before delivery (control group). Results The study revealed 1 481 cases of reported under-five mortality. 83.7% of that is by women who never had any antenatal care visit while the remaining 16.3% are by women who had at least one antenatal visit during their pregnancy. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 29% (CI = 1.3-56%, P= 0.04). Conclusions To achieve significant reduction in under-five mortality rate, Intervention programs that encourages antenatal care visits should be considered. This will improve child survival and help in attaining sustainable Development Goal target.