Level of completion along the continuum of care for maternity services and its associated factors among women who gave birth in the last 12 months in Bench Sheko zone, Southwest Ethiopia, 2022; A Multilevel analysis

Abstract

Background: Despite the significant benefit of the continuum of care to avert maternal and neonatal mortality and morbidity, still the dropout from the continuum of care remains high and continued to become a challenge in Ethiopia. However, there is a scarcity of shreds of evidence about the level of continuum of care for maternity services in the country level in general and previously no study has been done to assess its levels and factors associated with it in Bench Sheko zone of Southwest Ethiopia in particular. Objective: To assess the completion of the continuum of maternity services and its associated factors among women in the Bench Sheko zone, Southwest Ethiopia. Methods: A community-based cross-sectional study was conducted, from 1st February to 30th April/2022, on a total of 848 postpartum women nested in 21 kebeles recruited from a two-stage cluster sampling. Pretested structured questionnaires were used to collect data, entered using EpiData version 3.1, and analyzed by STATA version 14. To examine the effects of individual and cluster-level factors on the pillars of the continuum of care, a multilevel mixed effect logistic regression analysis was employed. A P-value less than 0.05 in the multilevel multivariable logistic regression analysis was considered statistically significant. Result: The overall magnitude of completion of the continuum of maternity services was 50.2%. Attending secondary and above education (AOR = 4: 95%CI; 1.71 – 9.33), had autonomous on maternity services uptake (AOR = 7.17: 95%CI; 3.61 – 14.25), had media exposure (AOR = 2.03: 95%CI; 1.14 – 3.61) and advised on danger signs of pregnancy during their ANC visits (AOR = 2.12: 95%CI; 1.54, 3.31) were positively associated with the completion of the continuum of maternity services. However, attending ANC visits lately (AOR = 0.29: 95%CI; 0.12, 0.72), being a rural resident (AOR = 0.12: 95%CI; 0.02 - 0.59) and distance from nearst health facility more than five kilometer (AOR = 0.20: 95%CI; 0.08 – 0.51) were negatively associated with the completion of the continuum of maternity services. Conclusion: The magnitude of the completion of the continuum of maternity services was low as compared to other studies. Improving female education and women’s empowerment through economic transitions with special attention given to rural residents could maximize the early initiation of first antenatal care visits. Furthermore, to increase complete uptake of maternity services, these determinants should be considered when designing new policies or updating policies and strategies on continuum of care uptake to help increase its completion, which can help in the reduction of maternal and neonatal mortality and to achieve sustainable development goals 3 by 2030.