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The dropout rate and associated factors of the continuum of maternal health care services before and during Covid-19 Pandemic among women who gave birth in the last two years in Addis Ababa, Ethiopia, 2021. A comparative cross-sectional study design


 Background

A continuum of maternal health care is the continuity of care during pregnancy, delivery, and post-delivery period. However, the dropout rate of the continuum care and factors associated with it during the COVID-19 pandemic were not well documented in the study setting. Hence, this study was used to assess the dropout rate and associated factors of the continuum of care before and during the COVID-19 pandemic.
Methods

A community-based comparative cross-sectional study was conducted among 630 women who gave birth in the last two years in Addis Ababa. An interviewer-administered questionnaires were used to collect the data. The Epi data version 4.6 and STATA version 14 statistical Softwares were used for data entry and analysis, respectively. Binary logistic regression model was used to identify associated factors of the dropout rate of a continuum of care.
Result

The dropout rate of the continuum of maternal healthcare was 58.39% (95% CI: 52.56-64.00) and 73.24% (95% CI: 67.91-77.98) before and during the covid-19 pandemic respectively. Women who had no information about PNC (AOR =1.88, 95% CI: 1.01-3.50), not received appropriate care (AOR = 3.92, 95% CI: 1.84-8.37), no information about maternal health care (AOR=2.57, 95% CI: 1.28-5.16), birth preparedness and complication readiness (AOR=0.47, 95% CI: 0.26-0.86), and had history of pregnancy-related complications (AOR=2.07, 95% CI: 1.17-3.68), were dropped out from continuum of care during the covid-19 pandemic. whereas, unplanned pregnancy (AOR= 3.35, 95% CI: 1.60-7.04), not know postpartum danger signs (AOR=1.79,95% CI: 1.03-3.12), and no information about maternal health care (AOR= 1.85, 95% CI: 1.06-3.23) were dropped out from continuum of care before covid-19 pandemic.
Conclusion

This study underscores nearly three fourth and more than half of women during and before the covid-19 pandemic dropped out from the continuum of care, respectively. Information about maternal health care, birth preparedness and complication readiness, information about PNC, and knowing postpartum danger signs were significantly associated with the dropout rate of the continuum of care. Thus, adapting policy that supports service delivery modification during such pandemic, promoting birth preparedness and complication readiness is very crucial.