# Maternity continuum of care and associated factors among mothers in south Ethiopia: a community-based cross-sectional study

## TL;DR

This study finds that only 23.7% of mothers in south Ethiopia completed the maternity care continuum, with education, access, and awareness being key factors.

## Contribution

The study identifies specific factors associated with maternity care continuity in a low-income Ethiopian setting.

## Key findings

- Only 23.7% of mothers completed the maternity continuum of care.
- Secondary education and shorter travel times to health facilities were strongly associated with care completion.
- Family planning use and awareness of postpartum complications also significantly influenced care continuity.

## Abstract

The maternity continuum of care (CoC) is crucial for improving maternal and neonatal health outcomes. Despite global initiatives like the SDGs and Every Woman Every Child, maternal health gaps remain in LMICs, especially sub-Saharan Africa, including Ethiopia. This study aims to assess the level of maternity CoC and identify factors associated with its utilization among mothers in Ethiopia.

A community-based cross-sectional study was conducted between January 15 and February 15, 2024, using a random sample of 564 mothers. Data were collected using a pretested structured questionnaire. Data was entered by EpiData 4.6 and analyzed with SPSS 25. Bi-variable and multivariable logistic regression identified associations, reported with adjusted odds ratios and 95% confidence intervals, with p-values <0.05 indicating significance.

Only 23.7% (95% CI: 19.6–27.6) of women completed the maternity continuum of care, highlighting significant gaps in maternal health service utilization. Factors significantly associated with this completion included Secondary and above education (AOR: 5.78, 95% CI: 2.63–12.76), reaching a health facility within 30 min (AOR: 3.71, 95% CI: 1.82–7.57), using family planning services (AOR: 5.13, 95% CI: 2.80–9.39), giving birth at a health facility (AOR: 3.37, 95% CI: 1.97–5.76), and awareness of postpartum complications (AOR: 2.49, 95% CI: 1.36–4.56).

Most mothers did not complete the continuum of maternal care. Key factors for completion of maternal care included secondary and above education, shorter travel times to health facilities, using family planning services, giving birth at health facilities, and awareness of postpartum complications. Enhancing these factors could improve maternal care continuity.