The proportion of dropouts from the maternity continuum of care and its predictors among antenatal booked women who gave birth in the last 12 months in Northwest Ethiopian women: a community-based cross-sectional study

Abstract

Introduction: maternity continuum of care is the continuity of maternity health care services that a woman uses in antenatal care, skill birth attendant, and postnatal care. This continuum of care in maternal health has become one of the government concerns and programs for planning and evaluating strategies within the currently existing maternal health system of Ethiopia. It is an important intervention in reducing maternal and neonatal morbidity and mortality. However, there is no clear information on the proportion of dropouts from the maternity continuum of care in Ethiopia. This study aimed to assess the proportion and associated factors of dropout from the maternity continuum of care among mothers who gave birth in the last 12 months in Debre Markos town, Northwest Ethiopia, 2018.

Methods: a dropout from the maternity continuum of care was considered as a woman who had at least one visit of antenatal care but did not use SBA and postnatal care. A community-based cross-sectional study with a cluster sampling technique was conducted among 605 mothers who gave birth in the last 12 months in Debre Markos town. The data were collected from August 1-30/ 2018 using face-to-face interviews through pretested and semi-structured questionnaires. Multivariable logistic regression models were fitted to determine factors associated with dropout from the maternity continuum of care. P<0.05 was considered statistically significant.

Results: the percentage of dropping out of the maternity continuum of care was found to be 32.2 % (95%CI: 28.4-36.2). No exposure to media (Adjusted Odds Ratio [AOR] = 2.62, CI: 1.47-4.68), women who heard about Postnatal care (AOR= 0.07, 95%CI: 0.04-0.15), unplanned pregnancy (AOR= 3.40, CI: 1.11-10.39), and having<4 Antenatal care follow up (AOR = 3.03, CI: 1.96-4.69) were statistically significant variables with the dropout from the maternity continuum of care.

Conclusion: in this study, the proportion of dropouts from the maternity continuum of care is found to be high. Interventions aiming to improve retention in ANC care should be given emphasis.