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Background: Full antenatal care utilization is a key intervention that creates the opportunity to provide all the necessary health services during pregnancy that aims to reduce maternal and newborn morbidity and mortality. However, there is still a gap in utilizing this service between rural and urban women. So, this study aimed to identify the sources of variations in full antenatal care utilization between the rural and urban areas of Ethiopia., Methods: The study used the data on a nationwide representative sample of the Mini- Demographic and Health Survey (DHS) of Ethiopia. The data were collected from March 21, 2019, to June 28, 2019, in all regions of Ethiopia. Two stage cluster sampling techniques were used to select the study participants. This study included about 3,927 (weighted samples) of women aged from 15 to 49 years. A multivariate decomposition analysis technique was performed to observe the rural-urban disparities in full antenatal care utilization explained by residence difference in components of endowments and coefficients., Results: The prevalence of full antenatal care utilization was 43.25% (95% CI: 41.7%, 44.8%). The difference in the prevalence of full antenatal care utilization between rural and urban women was (rural prevalence was 27.73%, while in urban areas it was 15.52%). These results showed a statistically significant full antenatal care utilization gap in rural urban resident women (-0.21807, 95% CI:(-0.27397, -0.16217)). The majority of the gap was explained by the covariate distribution, which accounted for 76.84%, and the rest, 23.16%, was due to the effect of covariate differences. Educational status, wealth status, religion, region, birth order, and parity differences between urban and rural women explain most of the full antenatal care utilization disparities., Conclusion and Recommendations: There is a significant full antenatal care utilization disparity between rural and urban women in Ethiopia. This variation in the rural-urban full antenatal care utilization was explained by differences in characteristics (endowment). So to decrease this gap, emphasis should be given to resource distribution targeting rural households, improvement of maternal education and creating a platform to access information about the service and its relevance., Competing Interests: All the authors have declared that no competing interests exist., (Copyright: © 2024 Addisu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Ethiopia has made strides in reducing maternal mortality, but significant discrepancies in maternal health service utilization exist across socioeconomic levels. According to studies, women from higher-income households are far more likely to use essential services such as antenatal care, delivery care, and postnatal care than poorer women. This wealth disparity is a primary contributor to persistently high maternal mortality, particularly among poor populations. The study's goal was to assess wealth disparities in maternal health service uptake and identify contributing factors., Methods and Materials: We used the Ethiopian Mini Demographic Health Survey (EMDHS), conducted in 2019 on women aged 15-49 living in selected census areas, with a weighted sample size of 3,909. The Erreygers Concentration Index (ECI) was used to measure wealth inequalities in maternal health care, and the ECI decomposition was used to identify factors contributing to inequality in maternal health services., Results: Maternal health service utilization was pro-rich among women in Ethiopia. The prevalence of antenatal care service (ANC), delivery, and postnatal care (PNC) service utilization showed a pro-rich distribution among Ethiopian women, with ECI = 0.115 (95% CI: 0.091-0.137), ECI = 0.223 (95% CI: 0.191-0.276), and ECI = 0.121 (95% CI: 0.041-0.200), respectively. The ECI indices were decomposed to examine the contributing factors to disparities in maternal service utilization in Ethiopia. Mother's current age, household family size, region, birth order, and parity were contributors to maternal health service utilization., Conclusion: The ANC service, delivery service and PNC service utilization showed a pro-rich distribution among Ethiopian women. Mother's current age, household family size, region, birth order, and parity are important contributors of maternal health service inequality. To improve access and usage among low-income women, policymakers can develop programs including increasing the number of free or subsidized services and providing transportation., (© 2024. The Author(s).)