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Health service utilization among pastoralists in Ethiopia is not well documented. Available data are very few and institution-based. Health services are particularly inadequate and poorly equipped, being scarce, inaccessible, and inappropriate to the pastoralist way of life. Effective antenatal care (ANC) use has been shown to influence women’s use of maternal health services, probably the most effective intervention in reducing maternal mortality in the developing world. Despite many studies done on ANC service utilization among agrarian women, the studies done on pastoralist women are almost negligible. Therefore, this study assesses utilization of ANC services among pastoralists of Afar Region, Ethiopia.A community cross-sectional study was carried out from 5 January to 5 February, 2015. The data was collected by interviews through a questionnaire. Statistical analyses were done to describe pertinent findings.Of 788 women, 42.4 % (334) made at least one ANC visit, while 19.5 % (65) had adequately utilized ANC (i.e. made four or more ANC visits). Only 9.7 % of women visited an ANC centre during the first trimester (12 weeks). Institutional delivery service utilization of the district was extremely low at 7.4 % (58). Educational status of the mother had a significant association with institutional delivery. Mothers who attended college/university were five times more likely to utilize delivery service than those mothers who are illiterate. ANC utilization in peri-urban areas was two times more than ANC utilization in rural areas with CI of 1.376, 3.595. Multivariate analyses, being in peri-urban residence (adjusted odds ratio (AOR) = 2.224; 95 % CI 1.38, 3.60), possessing radio/TV (AOR = 3.134; 95 % CI 2.204, 4.457), were positively associated with ANC service utilization.Every pregnant woman should receive at least four ANC visits, but only 20 % of the respondents were able to fulfil the recommendation. Pastoralist lifestyles, access, demographic, and socio-cultural barriers affect proper utilization of maternal health services. Increasing service coverage and promotion of available services in the community, accessible health services, transportation and improving information, education, and communication on maternal health services must be intensified to reach women in pastoralist communities of the country. Rigorous efforts are needed to reach disadvantaged groups so as to overcome health inequities between agrarian and disadvantaged pastoralist women.

Pastoralism and antenatal care service utilization in Dubti District, Afar, Ethiopia, 2015: A cross-sectional study