Level of utilization and factors associated with completion of maternal health care services along care continuum by women attending OPD at Nebbi General Hospital

Abstract

Introduction: A Continuum of maternal health services throughout pregnancy, childbirth, and postnatal care is an effective strategy for reducing maternal and newborn mortality. A low proportion of mothers achieve a complete continuum of maternal health care in Nebbi General Hospital. This study aimed to determine the level of utilization of maternal health services and factors associated with the completion of maternal health care along the care continuum. Methods: A facility-based cross-sectional study was conducted over two months in Nebbi General Hospital. Structured interviewer-administered questionnaires with two sections were administered. Section one comprised a data collection form on individual, cultural, and family characteristics, and section two comprised questions on the utilization of maternal health services along the care continuum. Both bivariable and multi-variable logistics regression analyses were done. Variables having p=0.05 in the bivariate analysis were entered into the multivariable logistic regression analysis to identify the factors significantly associated with the outcome variables. Adjusted odds ratio (aOR) with 95% CI and p=0.05. Results: In this study, only 14% of participants had complete maternal health services along the care continuum, which included four or more antenatal care visits/ contact with skilled health professionals, skilled delivery, and postnatal care. Factors that are significantly associated with the completion of maternal care include; older age (aOR= 3.23, 95% CI: 1.167-8.923, p=.024), participants living in an urban area (aOR=0.63, 95% CI:0.556-0.892 p=.042), participants with tertiary education (aOR=2.06, 95% CI:1.703-6.059 p=.018), and participants nationality (aOR=0.25, 95% CI:0.086-0.716 p=.010). Conclusion and Recommendations: Completion of maternal health care services along the care continuum was low (14%) in the study. Thus, efforts to improve the completion of care should focus on interventions that enhance early initiation of antenatal care, positive factors that influence the completion of maternal health care services, and enforcement of guidelines on adherence to maternal health care services along the care continuum.