The effects of completion of continuum of care in maternal health services on adverse birth outcomes in Northwestern Ethiopia: a prospective follow-up study

Abstract

Plain Language Summary Adverse birth outcomes are a major public health problem and a big challenge in Ethiopia, particularly in the study area. They encompass stillbirth, neonatal death, and neonatal illness within 28 days after birth. Globally, about 4 million babies die within the first month of birth annually with more than 3 million stillbirths. Of these, about 99% of newborn deaths and 98% of stillbirths occur in developing countries. As a solution to overcome those problems, a continuum of care in maternal health services is a core strategy. Therefore, this study was planned to determine how effective continuum of care in maternal health service is in reducing perinatal death and factors contributing to the adverse birth outcomes. In this study, 2198 pregnant women were recruited and followed for 11 months. The health condition of women was frequently assessed and recorded during pregnancy, childbirth and the period until 42 days after childbirth, as well as the health condition of the babies until 28 days after the birth, the package of maternal health services received, and adverse birth outcomes. Among the 2198 pregnant women enrolled in the study, 248 women encountered adverse birth outcomes (52 had stillbirths, 58 had neonatal death and 138 had neonatal illness). Risk factors of adverse birth outcomes were a poor household wealth index quintile, pregnancy-related maternal complications, offensive odor amniotic fluid, and history of stillbirth. On the other hand, protective interventions against adverse birth outcomes were receiving iron supplementation during pregnancy, initiating breastfeeding within 1 h, and immunizing the newborn. Moreover, completions of continuum of care in maternal health services via time and space dimensions reduced perinatal death. In conclusion, neonatal and perinatal deaths were high in the study areas. Completions of continuum of care in maternal health services via time and space dimensions reduced perinatal death, neonatal death, and stillbirth. The results of this study can inform national health policymakers, maternal and child programmers, and other stakeholders to prioritize and strengthen protective intervention and continuum of care in maternal health services.

Keywords

• Assosa town
• Benishangul Gumuz
• Continuum of care
• Maternal health
• Neonatal death
• Perinatal death