Factors Associated with the Completion of the Continuum of Care for Maternal, Newborn, and Child Health Services in Ethiopia. Multilevel Model Analysis

INTRODUCTION: Assuring completion of a continuum of maternal health care is a key program strategy to minimize morbidity and mortality of maternal and child. We aimed to examine completion of a continuum of care and its associated factors. METHODS: This cross-sectional study was analyzed from the 2016 Ethiopian Demographic and Health Survey data. Multilevel logistic regression was used to assess the relationship between completion of a continuum of care and independent variables, in which each individual woman (level-1) nested within a community (level-2). RESULTS: About 9.1% of Ethiopian women complete the continuum of care. Odds of completing continuum of care was more likely among those women formally employed (odds ratio, OR = 2.14; 95% confidence interval, CI: 1.37–3.35), from the female-headed household (OR = 1.58; 95% CI: 1.08–2.31), and gave birth at health facility (OR = 4.85; 95% CI: 1.75–13.37) than their counterpart. Maternal health services during antenatal care, such as blood pressure measured (OR = 4.31;95% CI: 2.47–7.52), informed about pregnancy complication (OR = 1.57;95% CI 1.61–2.11), and received tetanus injection (OR = 2.04; 95% CI: 1.42–2.92) were associated with completion of continuum of care. Similarly, the perception of women that money is not a problem in accessing healthcare (OR = 1.40; 95% CI: 1.03–1.90) was significantly associated with completion of a continuum of care. CONCLUSIONS: Most women failed to complete the continuum of care. Factors related to individual, community, access to health services, and services provided during antenatal care were positively affect completion of the continuum of care. Therefore, effort should focus on the integration of maternal health care services and targeting those factors facilitating the completion of the continuum of care.