PREVALENCE, INEQUALITIES,AND FACTORS ASSOCIATED WITHTHE COMPLETION OF CONTINUUM OF MATERNAL HEALTH CARE AMONG REPRODUCTIVE AGE WOMEN IN ETHIOPIA

Abstract

Background: The maternal continuum of care (CoC) is an approach that improves maternal health and significantly reduces the risk of maternal and neonatal mortality. However, there is dearth of recent evidence on the inequality and prevalence of maternal continuum of care in Eastern Africa including Ethiopia. Objectives: To assess the prevalence, inequalities, and factors associated with thecompletion of maternal continuum of care among reproductive age women in Ethiopia, 2019. Methods: A Population-based cross-sectional survey data from the 2019 mini-Ethiopian Demographic and Health Surveywas used. A total of 2,913 weighted samples of women who gave birth five years prior to the survey year were analyzed. Multilevel logistic regression was used to identify factors associated with maternal CoC. The concentration curve and concentration index were used to examine socioeconomic inequalities in maternal CoC. Result: The prevalence of completion of maternal continuum of carewas 23.97% (95% CI: 21.63, 26.48). Being urban resident (AOR= 1.59, 95% CI: 1.09, 2.33), attaining secondary (AOR= 1.67, 95% CI: 1.19, 2.33), and higher education (AOR= 1.93, 95% CI: 1.30, 2.87), and early initiation of ANC (AOR= 1.97, 95% CI: 1.61, 2.41)were positively associated with the completion of maternalCoC. However, belonging to pastoral region (Afar or Somali) (AOR= 0.46, 95% CI: 0.28, 0.77), belonging to poorest(AOR= 0.58, 95% CI: 0.37, 0.92) and middle (AOR= 0.62, 95% CI: 0.40, 0.96) wealth quintile, not being informed about obstetric danger signs (AOR= 0.54, 95% CI: 0.43, 0.66), and blood pressure not being measured (AOR = 0.53, 95% CI: 0.32, 0.85) were negatively associated with maternalCoC. The concentration index for completion of maternal CoC was 0.154 (95% CI: 0.045, 0.263) for urban and 0.146 (95% CI: 0.087, 0.205) for rural across their wealth status with p value ≤ 0.001. Conclusion and recommendation:Less than one-fourthof Ethiopian women completed the maternal CoC and there is significant inequality in the completion of maternal CoC across resident, educational status andsocioeconomic status. Focusing on educating female, improving economic status of the population, encouraging women to initiate ANC early, counseling on pregnancy danger signs, providing adequate ANC services should be considered. The CoC strategies and intervention should target women in rural areas, uneducated and economically deprived subgroups of women.