Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2022

Open Access 01-12-2022 | Care | Research

Multilevel analysis of the predictors of completion of the continuum of maternity care in Ethiopia; using the recent 2019 Ethiopia mini demographic and health survey

Authors: Gossa Fetene Abebe, Dereje Zeleke Belachew, Desalegn Girma, Alemseged Aydiko, Yilkal Negesse

Published in: BMC Pregnancy and Childbirth | Issue 1/2022

Login to get access

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. Therefore, this study aimed to assess the level of completion along the continuum of maternity care and its predictors among reproductive-age women in Ethiopia.

Methods

A secondary data analysis was done using the 2019 mini Ethiopian demographic health survey. A total weighted sample of 2,905 women aged 15–49 years who gave birth in the last five years preceding the survey and who had antenatal care visits was included. A multilevel mixed-effects logistic regression model was used to examine the predictors that affect the completion of the continuum of maternity care services. Finally, statistical significance was declared at a p-value < 0.05.

Results

In this study, the overall prevalence of completion along the continuum of maternity care was 12.9% (95%CI: 11.1 – 14.9%). Attending higher education (AOR = 2.03: 95%CI; 1.14 - 3.61), belonged to medium wealth status (AOR = 1.69: 95%CI; 1.07 - 2.66), belonged to rich wealth status (AOR = 2.05: 95%CI; 1.32, 3.17), and informed about danger signs during pregnancy (AOR = 2.23: 95%CI; 1.61, 3.10) were positively associated with the completion of the maternity continuum of care. However, late initiaton of first antenatal care visits (AOR = 0.66: 95%CI; 0.49, 0.89), being rural resident (AOR = 0.67: 95%CI; 0.42 - 0.93), lived in the Afar (AOR = 0.36: 95%CI; 0.12 – 0.83) and Gambella (AOR = 0.52: 95%CI; 0.19 – 0.95) regional states were negatively associated with the completion of the continuum of maternity care.

Conclusion

Despite most of the women using at least one of the maternity services, the level of completion along the continuum of care after antenatal care booking remains low in Ethiopia. Therefore, enhancing female education and economic transitions with special consideration given to rural, Afar, and Gambella regional state residents. Counseling towards the danger signs of pregnancy and its complications during antenatal care follow-upshould be strengthened. . Furthermore, the identified predictors should be considered when designing new policies or updating policies and strategies on maternity services uptake to step-up its full utilization, which in turn helps in the achievement of the sustainable development goals of ending preventable causes of maternal, neonatal, and child death by 2030.
Literature
4.
go back to reference Kassebaum NJ, Barber RM, Bhutta ZA, Dandona L, Gething PW, Hay SI, Kinfu Y, Larson HJ, Liang X, Lim SS. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1775–812.CrossRef Kassebaum NJ, Barber RM, Bhutta ZA, Dandona L, Gething PW, Hay SI, Kinfu Y, Larson HJ, Liang X, Lim SS. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1775–812.CrossRef
6.
go back to reference Campbell OM, Graham WJ, group LMSSs. Strategies for reducing maternal mortality: getting on with what works. The lancet. 2006;368(9543):1284–99.CrossRef Campbell OM, Graham WJ, group LMSSs. Strategies for reducing maternal mortality: getting on with what works. The lancet. 2006;368(9543):1284–99.CrossRef
7.
go back to reference Filippi V, Ronsmans C, Campbell OM, Graham WJ, Mills A, Borghi J, Koblinsky M, Osrin D. Maternal health in poor countries: the broader context and a call for action. The Lancet. 2006;368(9546):1535–41.CrossRef Filippi V, Ronsmans C, Campbell OM, Graham WJ, Mills A, Borghi J, Koblinsky M, Osrin D. Maternal health in poor countries: the broader context and a call for action. The Lancet. 2006;368(9546):1535–41.CrossRef
8.
go back to reference Kerber KJ, de Graft-Johnson JE, Bhutta ZA, Okong P, Starrs A, Lawn JE. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. The Lancet. 2007;370(9595):1358–69.CrossRef Kerber KJ, de Graft-Johnson JE, Bhutta ZA, Okong P, Starrs A, Lawn JE. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. The Lancet. 2007;370(9595):1358–69.CrossRef
12.
go back to reference Marchant T, Tilley-Gyado RD, Tessema T, Singh K, Gautham M, Umar N, Berhanu D, Cousens S, Armstrong Schellenberg JR. Adding content to contacts: measurement of high quality contacts for maternal and newborn health in Ethiopia, north east Nigeria, and Uttar Pradesh, India. PLoS One. 2015;10(5):e0126840.PubMedPubMedCentralCrossRef Marchant T, Tilley-Gyado RD, Tessema T, Singh K, Gautham M, Umar N, Berhanu D, Cousens S, Armstrong Schellenberg JR. Adding content to contacts: measurement of high quality contacts for maternal and newborn health in Ethiopia, north east Nigeria, and Uttar Pradesh, India. PLoS One. 2015;10(5):e0126840.PubMedPubMedCentralCrossRef
13.
go back to reference Heredia-Pi I, Servan-Mori E, Darney BG, Reyes-Morales H, Lozano R. Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico. Bull World Health Organ. 2016;94(6):452.PubMedPubMedCentralCrossRef Heredia-Pi I, Servan-Mori E, Darney BG, Reyes-Morales H, Lozano R. Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico. Bull World Health Organ. 2016;94(6):452.PubMedPubMedCentralCrossRef
14.
go back to reference Sinyange N, Sitali L, Jacobs C, Musonda P, Michelo C. Factors associated with late antenatal care booking: population based observations from the 2007 Zambia demographic and health survey. Pan Afr Med J. 2016;25:10.CrossRef Sinyange N, Sitali L, Jacobs C, Musonda P, Michelo C. Factors associated with late antenatal care booking: population based observations from the 2007 Zambia demographic and health survey. Pan Afr Med J. 2016;25:10.CrossRef
15.
go back to reference Fekadu GA, Ambaw F, Kidanie SA. Facility delivery and postnatal care services use among mothers who attended four or more antenatal care visits in Ethiopia: further analysis of the 2016 demographic and health survey. BMC Pregnancy Childbirth. 2019;19(1):1–9.CrossRef Fekadu GA, Ambaw F, Kidanie SA. Facility delivery and postnatal care services use among mothers who attended four or more antenatal care visits in Ethiopia: further analysis of the 2016 demographic and health survey. BMC Pregnancy Childbirth. 2019;19(1):1–9.CrossRef
16.
go back to reference Moyer CA, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reprod Health. 2013;10(1):1–14.CrossRef Moyer CA, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reprod Health. 2013;10(1):1–14.CrossRef
17.
go back to reference Baqui AH, Ahmed S, Begum N, Khanam R, Mohan D, Harrison M, Al Kabir A, McKaig C, Brandes N, Norton M. Impact of integrating a postpartum family planning program into a community-based maternal and newborn health program on birth spacing and preterm birth in rural Bangladesh. J Global Health. 2018;8(2):020406.CrossRef Baqui AH, Ahmed S, Begum N, Khanam R, Mohan D, Harrison M, Al Kabir A, McKaig C, Brandes N, Norton M. Impact of integrating a postpartum family planning program into a community-based maternal and newborn health program on birth spacing and preterm birth in rural Bangladesh. J Global Health. 2018;8(2):020406.CrossRef
18.
go back to reference Lassi ZS, Majeed A, Rashid S, Yakoob MY, Bhutta ZA. The interconnections between maternal and newborn health–evidence and implications for policy. J Matern Fetal Neonatal Med. 2013;26(sup1):3–53.PubMedCrossRef Lassi ZS, Majeed A, Rashid S, Yakoob MY, Bhutta ZA. The interconnections between maternal and newborn health–evidence and implications for policy. J Matern Fetal Neonatal Med. 2013;26(sup1):3–53.PubMedCrossRef
19.
go back to reference Bashour HN, Kharouf MH, AbdulSalam AA, El Asmar K, Tabbaa MA, Cheikha SA. Effect of postnatal home visits on maternal/infant outcomes in Syria: a randomized controlled trial. Public Health Nurs. 2008;25(2):115–25.PubMedCrossRef Bashour HN, Kharouf MH, AbdulSalam AA, El Asmar K, Tabbaa MA, Cheikha SA. Effect of postnatal home visits on maternal/infant outcomes in Syria: a randomized controlled trial. Public Health Nurs. 2008;25(2):115–25.PubMedCrossRef
20.
go back to reference Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2014;14(1):1–10.CrossRef Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2014;14(1):1–10.CrossRef
21.
go back to reference Lindtjørn B, Mitiku D, Zidda Z, Yaya Y. Reducing maternal deaths in Ethiopia: results of an intervention Programme in Southwest Ethiopia. PLoS One. 2017;12(1):e0169304.PubMedPubMedCentralCrossRef Lindtjørn B, Mitiku D, Zidda Z, Yaya Y. Reducing maternal deaths in Ethiopia: results of an intervention Programme in Southwest Ethiopia. PLoS One. 2017;12(1):e0169304.PubMedPubMedCentralCrossRef
22.
go back to reference Pearson L, Gandhi M, Admasu K, Keyes EB. User fees and maternity services in Ethiopia. Int J Gynecol Obstet. 2011;115:310–5 (BMC pregnancy and childbirth).CrossRef Pearson L, Gandhi M, Admasu K, Keyes EB. User fees and maternity services in Ethiopia. Int J Gynecol Obstet. 2011;115:310–5 (BMC pregnancy and childbirth).CrossRef
24.
go back to reference Medhanyie A, Spigt M, Kifle Y, Schaay N, Sanders D, Blanco R, GeertJan D, Berhane Y. The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study. BMC Health Serv Res. 2012;12(1):1–9.CrossRef Medhanyie A, Spigt M, Kifle Y, Schaay N, Sanders D, Blanco R, GeertJan D, Berhane Y. The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study. BMC Health Serv Res. 2012;12(1):1–9.CrossRef
27.
go back to reference Chaka EE, Parsaeian M, Majdzadeh R. Factors associated with the completion of the continuum of care for maternal, newborn, and child health services in Ethiopia. Multilevel model analysis. Int J Prev Med. 2019;10:136.PubMedPubMedCentralCrossRef Chaka EE, Parsaeian M, Majdzadeh R. Factors associated with the completion of the continuum of care for maternal, newborn, and child health services in Ethiopia. Multilevel model analysis. Int J Prev Med. 2019;10:136.PubMedPubMedCentralCrossRef
28.
go back to reference Muluneh AG, Kassa GM, Alemayehu GA, Merid MW. High dropout rate from maternity continuum of care after antenatal care booking and its associated factors among reproductive age women in Ethiopia, Evidence from Demographic and Health Survey 2016. PLoS One. 2020;15(6):e0234741.PubMedPubMedCentralCrossRef Muluneh AG, Kassa GM, Alemayehu GA, Merid MW. High dropout rate from maternity continuum of care after antenatal care booking and its associated factors among reproductive age women in Ethiopia, Evidence from Demographic and Health Survey 2016. PLoS One. 2020;15(6):e0234741.PubMedPubMedCentralCrossRef
29.
go back to reference Asratie MH, Muche AA, Geremew AB. Completion of maternity continuum of care among women in the post-partum period: Magnitude and associated factors in the northwest, Ethiopia. PLoS One. 2020;15(8):e0237980.PubMedPubMedCentralCrossRef Asratie MH, Muche AA, Geremew AB. Completion of maternity continuum of care among women in the post-partum period: Magnitude and associated factors in the northwest, Ethiopia. PLoS One. 2020;15(8):e0237980.PubMedPubMedCentralCrossRef
30.
go back to reference Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, Fat DM, Boerma T, Temmerman M, Mathers C. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2016;387(10017):462–74.PubMedCrossRef Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, Fat DM, Boerma T, Temmerman M, Mathers C. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2016;387(10017):462–74.PubMedCrossRef
31.
go back to reference Dadi TL, Medhin G, Kasaye HK, Kassie GM, Jebena MG, Gobezie WA, Alemayehu YK, Teklu AM. Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter? Reprod Health. 2021;18(1):1–12.CrossRef Dadi TL, Medhin G, Kasaye HK, Kassie GM, Jebena MG, Gobezie WA, Alemayehu YK, Teklu AM. Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter? Reprod Health. 2021;18(1):1–12.CrossRef
32.
go back to reference Tsega D, Admas M, Talie A, Tsega TB, Birhanu MY, Alemu S, Mengist B. Maternity Continuum Care Completion and Its Associated Factors in Northwest Ethiopia. J Pregnancy. 2022;2022:1309881.PubMedPubMedCentralCrossRef Tsega D, Admas M, Talie A, Tsega TB, Birhanu MY, Alemu S, Mengist B. Maternity Continuum Care Completion and Its Associated Factors in Northwest Ethiopia. J Pregnancy. 2022;2022:1309881.PubMedPubMedCentralCrossRef
33.
go back to reference Sertsewold SG, Debie A, Geberu DM. Continuum of maternal healthcare services utilisation and associated factors among women who gave birth in Siyadebirena Wayu district, Ethiopia: community-based cross-sectional study. BMJ Open. 2021;11(11):e051148.PubMedPubMedCentralCrossRef Sertsewold SG, Debie A, Geberu DM. Continuum of maternal healthcare services utilisation and associated factors among women who gave birth in Siyadebirena Wayu district, Ethiopia: community-based cross-sectional study. BMJ Open. 2021;11(11):e051148.PubMedPubMedCentralCrossRef
34.
go back to reference Tizazu MA, Sharew NT, Mamo T, Zeru AB, Asefa EY, Amare NS. Completing the Continuum of Maternity Care and Associated Factors in Debre Berhan Town, Amhara, Ethiopia, 2020. J Multidiscip Healthc. 2021;14:21.PubMedPubMedCentralCrossRef Tizazu MA, Sharew NT, Mamo T, Zeru AB, Asefa EY, Amare NS. Completing the Continuum of Maternity Care and Associated Factors in Debre Berhan Town, Amhara, Ethiopia, 2020. J Multidiscip Healthc. 2021;14:21.PubMedPubMedCentralCrossRef
35.
go back to reference Wang W, Hong R. Levels and determinants of continuum of care for maternal and newborn health in Cambodia-evidence from a population-based survey. BMC Pregnancy Childbirth. 2015;15(1):1–9.CrossRef Wang W, Hong R. Levels and determinants of continuum of care for maternal and newborn health in Cambodia-evidence from a population-based survey. BMC Pregnancy Childbirth. 2015;15(1):1–9.CrossRef
36.
go back to reference Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R. Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis. Reprod Health. 2017;14(1):1–17.CrossRef Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R. Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis. Reprod Health. 2017;14(1):1–17.CrossRef
37.
go back to reference Alemi Kebede KH, Teklehaymanot AN. Factors associated with institutional delivery service utilization in Ethiopia. Int J Women’s Health. 2016;8:463.CrossRef Alemi Kebede KH, Teklehaymanot AN. Factors associated with institutional delivery service utilization in Ethiopia. Int J Women’s Health. 2016;8:463.CrossRef
38.
go back to reference Chaka EE, Abdurahman AA, Nedjat S, Majdzadeh R. Utilization and determinants of postnatal care services in Ethiopia: a systematic review and meta-analysis. Ethiopian J Health Sci. 2019;29(1):935–44. Chaka EE, Abdurahman AA, Nedjat S, Majdzadeh R. Utilization and determinants of postnatal care services in Ethiopia: a systematic review and meta-analysis. Ethiopian J Health Sci. 2019;29(1):935–44.
39.
go back to reference Bryce J, Arnold F, Blanc A, Hancioglu A, Newby H, Requejo J, Wardlaw T, Measurement CWGoIC. Measuring coverage in MNCH: new findings, new strategies, and recommendations for action. PLoS Med. 2013;10(5):e1001423.PubMedPubMedCentralCrossRef Bryce J, Arnold F, Blanc A, Hancioglu A, Newby H, Requejo J, Wardlaw T, Measurement CWGoIC. Measuring coverage in MNCH: new findings, new strategies, and recommendations for action. PLoS Med. 2013;10(5):e1001423.PubMedPubMedCentralCrossRef
40.
go back to reference Institute EPH, ICF. Ethiopia mini demographic and health survey 2019: key indicators. Rockville, Maryland: EPHI and ICF; 2019. Institute EPH, ICF. Ethiopia mini demographic and health survey 2019: key indicators. Rockville, Maryland: EPHI and ICF; 2019.
41.
go back to reference Emiru AA, Alene GD, Debelew GT. Women’s retention on the continuum of maternal care pathway in west Gojjam zone, Ethiopia: multilevel analysis. BMC Pregnancy Childbirth. 2020;20(1):1–14.CrossRef Emiru AA, Alene GD, Debelew GT. Women’s retention on the continuum of maternal care pathway in west Gojjam zone, Ethiopia: multilevel analysis. BMC Pregnancy Childbirth. 2020;20(1):1–14.CrossRef
42.
go back to reference Ayele BG, Woldu MA, Gebrehiwot HW, Gebre-Egziabher EG, Gebretnsae H, Hadgu T, Abrha AA, Medhanyie AA. Magnitude and determinants for place of postnatal care utilization among mothers who delivered at home in Ethiopia: a multinomial analysis from the 2016 Ethiopian demographic health survey. Reprod Health. 2019;16(1):1–10.CrossRef Ayele BG, Woldu MA, Gebrehiwot HW, Gebre-Egziabher EG, Gebretnsae H, Hadgu T, Abrha AA, Medhanyie AA. Magnitude and determinants for place of postnatal care utilization among mothers who delivered at home in Ethiopia: a multinomial analysis from the 2016 Ethiopian demographic health survey. Reprod Health. 2019;16(1):1–10.CrossRef
43.
go back to reference Merlo J, Chaix B, Yang M, Lynch J, Råstam L. A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. J Epidemiol Community Health. 2005;59(6):443–9.PubMedPubMedCentralCrossRef Merlo J, Chaix B, Yang M, Lynch J, Råstam L. A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. J Epidemiol Community Health. 2005;59(6):443–9.PubMedPubMedCentralCrossRef
44.
go back to reference Akinyemi JO, Afolabi RF, Awolude OA. Patterns and determinants of dropout from maternity care continuum in Nigeria. BMC Pregnancy Childbirth. 2016;16(1):1–11.CrossRef Akinyemi JO, Afolabi RF, Awolude OA. Patterns and determinants of dropout from maternity care continuum in Nigeria. BMC Pregnancy Childbirth. 2016;16(1):1–11.CrossRef
45.
go back to reference Singh K, Story WT, Moran AC. Assessing the continuum of care pathway for maternal health in South Asia and sub-Saharan Africa. Matern Child Health J. 2016;20(2):281–9.PubMedPubMedCentralCrossRef Singh K, Story WT, Moran AC. Assessing the continuum of care pathway for maternal health in South Asia and sub-Saharan Africa. Matern Child Health J. 2016;20(2):281–9.PubMedPubMedCentralCrossRef
46.
go back to reference Haile D, Kondale M, Andarge E, Tunje A, Fikadu T, Boti N. Level of completion along continuum of care for maternal and newborn health services and factors associated with it among women in Arba Minch Zuria woreda, Gamo zone, Southern Ethiopia: a community based cross-sectional study. PLoS One. 2020;15(6):e0221670.PubMedPubMedCentralCrossRef Haile D, Kondale M, Andarge E, Tunje A, Fikadu T, Boti N. Level of completion along continuum of care for maternal and newborn health services and factors associated with it among women in Arba Minch Zuria woreda, Gamo zone, Southern Ethiopia: a community based cross-sectional study. PLoS One. 2020;15(6):e0221670.PubMedPubMedCentralCrossRef
47.
go back to reference Yeji F, Shibanuma A, Oduro A, Debpuur C, Kikuchi K, Owusu-Agei S, Gyapong M, Okawa S, Ansah E, Asare GQ. Continuum of care in a maternal, newborn and child health program in Ghana: low completion rate and multiple obstacle factors. PLoS One. 2015;10(12):e0142849.PubMedPubMedCentralCrossRef Yeji F, Shibanuma A, Oduro A, Debpuur C, Kikuchi K, Owusu-Agei S, Gyapong M, Okawa S, Ansah E, Asare GQ. Continuum of care in a maternal, newborn and child health program in Ghana: low completion rate and multiple obstacle factors. PLoS One. 2015;10(12):e0142849.PubMedPubMedCentralCrossRef
48.
go back to reference Mohan D, LeFevre AE, George A, Mpembeni R, Bazant E, Rusibamayila N, Killewo J, Winch PJ, Baqui AH. Analysis of dropout across the continuum of maternal health care in Tanzania: findings from a cross-sectional household survey. Health Policy Plan. 2017;32(6):791–9.PubMedCrossRef Mohan D, LeFevre AE, George A, Mpembeni R, Bazant E, Rusibamayila N, Killewo J, Winch PJ, Baqui AH. Analysis of dropout across the continuum of maternal health care in Tanzania: findings from a cross-sectional household survey. Health Policy Plan. 2017;32(6):791–9.PubMedCrossRef
49.
go back to reference Tamang TM: Factors associated with completion of continuum of Care for Maternal Health in Nepal. In: IUSSP XXVIII International Population Conference, Cape Town, South Africa: 2017; 2017. Tamang TM: Factors associated with completion of continuum of Care for Maternal Health in Nepal. In: IUSSP XXVIII International Population Conference, Cape Town, South Africa: 2017; 2017.
50.
go back to reference Hamed A, Mohamed E, Sabry M. Egyptian status of continuum of care for maternal, newborn, and child health: Sohag Governorate as an example. Int J Med Sci Public Health. 2018;7(6):1.CrossRef Hamed A, Mohamed E, Sabry M. Egyptian status of continuum of care for maternal, newborn, and child health: Sohag Governorate as an example. Int J Med Sci Public Health. 2018;7(6):1.CrossRef
51.
go back to reference Iqbal S, Maqsood S, Zakar R, Zakar MZ, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Serv Res. 2017;17(1):1–15.CrossRef Iqbal S, Maqsood S, Zakar R, Zakar MZ, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Serv Res. 2017;17(1):1–15.CrossRef
52.
go back to reference Shitie A, Assefa N, Dhressa M, Dilnessa T. Completion and factors associated with maternity continuum of care among mothers who gave birth in the last one year in Enemay district, Northwest Ethiopia. J Pregnancy. 2020;2020:7019676.PubMedPubMedCentralCrossRef Shitie A, Assefa N, Dhressa M, Dilnessa T. Completion and factors associated with maternity continuum of care among mothers who gave birth in the last one year in Enemay district, Northwest Ethiopia. J Pregnancy. 2020;2020:7019676.PubMedPubMedCentralCrossRef
54.
go back to reference Elo IT. Utilization of maternal health-care services in Peru: the role of women’s education. Health Trans Rev. 1992;2(1):49–69. Elo IT. Utilization of maternal health-care services in Peru: the role of women’s education. Health Trans Rev. 1992;2(1):49–69.
55.
go back to reference Gong E, Dula J, Alberto C, de Albuquerque A, Steenland M, Fernandes Q, Cuco RM, Sequeira S, Chicumbe S, Gudo ES. Client experiences with antenatal care waiting times in southern Mozambique. BMC Health Serv Res. 2019;19(1):1–9.CrossRef Gong E, Dula J, Alberto C, de Albuquerque A, Steenland M, Fernandes Q, Cuco RM, Sequeira S, Chicumbe S, Gudo ES. Client experiences with antenatal care waiting times in southern Mozambique. BMC Health Serv Res. 2019;19(1):1–9.CrossRef
56.
go back to reference Kalu-Umeh NN, Sambo MN, Idris SH, Kurfi AM. Costs and patterns of financing maternal health care services in rural communities in northern Nigeria: evidence for designing national fee exemption policy. Int J MCH AIDS. 2013;2(1):163.PubMedPubMedCentralCrossRef Kalu-Umeh NN, Sambo MN, Idris SH, Kurfi AM. Costs and patterns of financing maternal health care services in rural communities in northern Nigeria: evidence for designing national fee exemption policy. Int J MCH AIDS. 2013;2(1):163.PubMedPubMedCentralCrossRef
59.
go back to reference Tiruneh GT, Worku A, Berhane Y, Betemariam W, Demissie M. Determinants of postnatal care utilization in Ethiopia: a multilevel analysis. BMC Pregnancy Childbirth. 2020;20(1):1–12.CrossRef Tiruneh GT, Worku A, Berhane Y, Betemariam W, Demissie M. Determinants of postnatal care utilization in Ethiopia: a multilevel analysis. BMC Pregnancy Childbirth. 2020;20(1):1–12.CrossRef
60.
go back to reference Wang W, Hong R. The continuum of care for maternal and newborn health in Cambodia: where are the gaps and why? A population-based study. Lancet. 2013;381:S145.CrossRef Wang W, Hong R. The continuum of care for maternal and newborn health in Cambodia: where are the gaps and why? A population-based study. Lancet. 2013;381:S145.CrossRef
61.
go back to reference Dadi LS, Berhane M, Ahmed Y, Gudina EK, Berhanu T, Kim KH, Getnet M, Abera M. Maternal and newborn health services utilization in Jimma Zone, Southwest Ethiopia: a community based cross-sectional study. BMC Pregnancy Childbirth. 2019;19(1):1–13.CrossRef Dadi LS, Berhane M, Ahmed Y, Gudina EK, Berhanu T, Kim KH, Getnet M, Abera M. Maternal and newborn health services utilization in Jimma Zone, Southwest Ethiopia: a community based cross-sectional study. BMC Pregnancy Childbirth. 2019;19(1):1–13.CrossRef
63.
go back to reference Yeneneh A, Alemu K, Dadi AF, Alamirrew A. Spatial distribution of antenatal care utilization and associated factors in Ethiopia: evidence from Ethiopian demographic health surveys. BMC Pregnancy Childbirth. 2018;18(1):1–12.CrossRef Yeneneh A, Alemu K, Dadi AF, Alamirrew A. Spatial distribution of antenatal care utilization and associated factors in Ethiopia: evidence from Ethiopian demographic health surveys. BMC Pregnancy Childbirth. 2018;18(1):1–12.CrossRef
Metadata
Title
Multilevel analysis of the predictors of completion of the continuum of maternity care in Ethiopia; using the recent 2019 Ethiopia mini demographic and health survey
Authors
Gossa Fetene Abebe
Dereje Zeleke Belachew
Desalegn Girma
Alemseged Aydiko
Yilkal Negesse
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Care
Published in
BMC Pregnancy and Childbirth / Issue 1/2022
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-022-05016-z

Other articles of this Issue 1/2022

BMC Pregnancy and Childbirth 1/2022 Go to the issue