Level of completing continuum maternity care and the associated factors in the pastoralist and agrarian districts of the Ari and South Omo zones, Ethiopia, 2024: a comparative study.

Abstract

Completing continuous maternity care (COCMC) is crucial for preventing morbidity and mortality, but a low proportion of mothers use it. There is a paucity of evidence about the level of COCMC and the associated factors in agro-pastoralist communities. To identify and compare the level of COCMC and associated factors among pastoralist and agrarian communities in Ari and South Omo zones. A community-based comparative cross-sectional study was conducted from March to May 2024. A comparative study on COCMC was conducted in Ari and South Omo zones of South Ethiopia. A multistage sampling technique was employed to select 632 women who gave birth 6 months before data collection. The outcome variables were the level of COCMC and its associated factors. The results of outcome variables were presented with proportions and adjusted ORs (AORs) with the corresponding 95% CIs. Data were collected with a standard questionnaire via the Kobo toolbox and analysed with the R software. Due to sparse data about the proportion of COCMC, a penalised likelihood (Firth logistic regression) model was employed. A p value <0.05 was considered a cut-off for statistical significance. A total of 632 women participated in this study giving the response rate of 97.4%. The overall level of COCMC was 46 (7.3%; 95% CI 5.3% to 9.3%), 27 (7.5%) among pastoralists and 19 (7.0%) among agrarian districts, the difference was not statistically significant (p value=0.84). The COCMC was associated with living in urban areas (AOR: 2.76, 95% CI 1.17 to 6.34), women's ability to pass a decision on household resources (AOR: 2.57, 95% CI 1.17 to 5.55), being a government employee (AOR: 8.71, 95% CI 1.38 to 50.94), middle level household economy (AOR: 3.81, 95% CI 1.16 to 15.83) and receiving no home-to-home healthcare (AOR: 0.33, 95% CI 0.14 to 0.70). The level of COCMC is low in the study area. Therefore, equitable interventions targeting both communities, enhancing maternal decision-making power to use resources for maternal services, focusing on the housewives and those engaged in daily work and strengthening integrated home-based healthcare are all recommended.