Maternity continuum of care and its determinants among mothers who gave birth in Legambo district, South Wollo, northeast Ethiopia

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Abstract

Background

Maternity continuum of care is the continuity of maternity health care services that a woman uses for antenatal care, skill birth attendant, and postnatal care. Maternal and child mortality is still big challenge in Ethiopia. Little is known about continuum of maternity care in Ethiopia and where the study area in the district revealed that there is a big discrepancy in the completion of maternity care.

Objective

Assessment of maternity continuum of care and associated factors among mothers who gave birth in Legambo district, South, Wollo, and northeast Ethiopia.

Method

A community‐based cross‐sectional study design was conducted among 732 mothers from Feb‐Mar 2020. Multistage sampling was used and data were collected through face‐to‐face interviewer‐administered semi‐structured questionnaire. Completed data were entered using Epi‐Data version 3.1, cleaned, and analyzed using SPSS version 25 Statistical Software. Descriptive statistics using Frequency, proportion, summary measures were done. Binary logistic regressions were and model fitness was checked by Hosmer and Lemeshow test which was not significant. Multivariable logistic regression was conducted and P value less than .05 and adjusted odds ratio with 95% confidence interval was considered as statistically significant.

Result

The prevalence of maternity continuum of care among mother was found 11.2% (95%, CI: 9.0‐13.8). Residence (AOR:1.837, CI:1.026‐3.288), planned pregnancy (AOR: 2.448, CI:1.361‐4.403), prepregnancy contraceptive utilization (AOR: 2.721, CI:1.469‐5.042), follow mass media (AOR: 2.33, CI:1.146‐4.736) and mother health care decision making autonomy (AOR: 3.712, CI:1.924‐7.161) were determinant factors to continuum of maternity care.

Conclusion

The prevalence of maternity continuum of care in the district was low. Information education and counseling about continuum of care are still crucial. Awareness creation for both clients and care provider will improve the service. Efforts on improving and cultivating those significant factors should be done by stakeholders.

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Most cited references 31

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Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence.

Zulfiqar Bhutta, Gary Darmstadt, Babar Hasan … (2005)

Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developing-country communities has not been reported. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in community-based neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy makers about the importance of investing in neonatal health.

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Being a bridge: Swedish antenatal care midwives’ encounters with Somali-born women and questions of violence; a qualitative study

Ulrika Byrskog, Pia Olsson, Birgitta Essén … (2015)

Background Violence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence. Methods Qualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis. Results The midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women’s’ strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman’s access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women. Conclusion Focus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives’ ability to identify Somali born woman’s resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the midwife can be a bridge and contribute to increased awareness of rights and support for Somali-born women in a new society.

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Continuum of care for maternal, newborn, and child health: from slogan to service delivery.

Kate J. Kerber, Joseph de Graft–Johnson, Zulfiqar Bhutta … (2007)

The continuum of care has become a rallying call to reduce the yearly toll of half a million maternal deaths, 4 million neonatal deaths, and 6 million child deaths. The continuum for maternal, newborn, and child health usually refers to continuity of individual care. Continuity of care is necessary throughout the lifecycle (adolescence, pregnancy, childbirth, the postnatal period, and childhood) and also between places of caregiving (including households and communities, outpatient and outreach services, and clinical-care settings). We define a population-level or public-health framework based on integrated service delivery throughout the lifecycle, and propose eight packages to promote health for mothers, babies, and children. These packages can be used to deliver more than 190 separate interventions, which would be difficult to scale up one by one. The packages encompass three which are delivered through clinical care (reproductive health, obstetric care, and care of sick newborn babies and children); four through outpatient and outreach services (reproductive health, antenatal care, postnatal care and child health services); and one through integrated family and community care throughout the lifecycle. Mothers and babies are at high risk in the first days after birth, and the lack of a defined postnatal care package is an important gap, which also contributes to discontinuity between maternal and child health programmes. Similarly, because the family and community package tends not to be regarded as part of the health system, few countries have made systematic efforts to scale it up or integrate it with other levels of care. Building the continuum of care for maternal, newborn, and child health with these packages will need effectiveness trials in various settings; policy support for integration; investment to strengthen health systems; and results-based operational management, especially at district level.

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Author and article information

Contributors

Niguss Cherie:

ORCID: https://orcid.org/0000-0002-3497-2663

nigucheru@gmail.com

Journal

Journal ID (nlm-ta): Health Sci Rep

Journal ID (iso-abbrev): Health Sci Rep

Journal ID (doi): 10.1002/(ISSN)2398-8835

Journal ID (publisher-id): HSR2

Title: Health Science Reports

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Electronic): 2398-8835

Publication date (Electronic): 02 November 2021

Publication date Collection: December 2021

Volume: 4

Issue: 4 ( doiID: 10.1002/hsr2.v4.4 )

Electronic Location Identifier: e409

Affiliations

[ ¹ ] Reproductive and Family Health Department School of Public Health, College of Medicine and Health Sciences, Wollo University Dessie Ethiopia

[ ² ] Reproductive and Family health Legambo District Health Office South Wollo Ethiopia

[ ³ ] Epidemiology and Biostatics Department, School of Public Health College of Medicine and Health Sciences, Wollo University Dessie Ethiopia

Author notes

[*] [* ] Correspondence

Niguss Cherie, Reproductive and family health department, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO.BOX:1145, Dessie, Ethiopia.

Email: nigucheru@ 123456gmail.com

Author information

Niguss Cherie https://orcid.org/0000-0002-3497-2663

Zinet Abegaz https://orcid.org/0000-0002-2542-7671

Getaw Walle Baze https://orcid.org/0000-0002-0372-8537

Article

Publisher ID: HSR2409

DOI: 10.1002/hsr2.409

PMC ID: 8562404

SO-VID: 739dc9b6-e941-41e9-8ed8-58ed86ade098

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date revision received : 01 September 2021

Date received : 09 July 2021

Date accepted : 06 September 2021

Page count

Figures: 0, Tables: 4, Pages: 8, Words: 5314

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cover-date December 2021

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.8 mode:remove_FC converted:02.11.2021

Maternity continuum of care and its determinants among mothers who gave birth in Legambo district, South Wollo, northeast Ethiopia

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Most cited references 31

Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence.

Being a bridge: Swedish antenatal care midwives’ encounters with Somali-born women and questions of violence; a qualitative study

Continuum of care for maternal, newborn, and child health: from slogan to service delivery.

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