Dropout from Maternity Continuum of Care and Associated Factors Among Mothers in Arabsiyo District, Marodijeh Region, Somaliland: A Community-based Cross-Sectional Study

Abstract

<title>Abstract</title> <bold>Background</bold> Dropout from the maternity continuum of care is defined as not having ANC 4 and more visits during pregnancy, delivering out of a health facility, and not having a postnatal check-up. The continuum of care for maternal health in Sub-Saharan countries is low. In 2021, the overall utilization of maternal health care in Sub-Saharan countries showed 87.9%. The aim of this study is to determine dropout from maternity continuum care and associated factors among mothers in Arabsiyo Community, Gabiley District, Somaliland <bold>Methods</bold> Community Based Cross-section study was employed among mothers in Arabsiyo District, Somaliland. A total of 273 mothers were interviewed using simple random sampling technique. Quantitative data was collected using a semi-structured questionnaire. SPSS version 25 was entered and analyzed the data. Descriptive statistics, bivariate and multivariable logistic regression analysis was performed to summarize the findings and <italic>p</italic>-value of &lt;0.05 was considered statistically significant. <bold>Results</bold> The overall dropout from the maternity continuum of care is 78.4% (95% CI: 72.8 - 83.2%). Mothers who did not receive information about maternal health such ANC, Institutional delivery, and PNC were (AOR=4.29, 95% CI: 2.29 - 8.00, <italic>P-value</italic> &lt;0.01). Similarly, Mothers who were not satisfied with ANC, Institutional delivery, and postanal care services had (AOR=3.07, 95% CI: 1.53 - 6.16, <italic>P-value</italic> &lt;0.01). Mothers who resident rural were (AOR 2.03, 95% Cl: 1.13 - 3.65, <italic>P-value</italic> &lt;0.01) were associated factors with the dropouts from maternity continuum of care. <bold>Conclusions</bold> Identifying wherever drop-out arises can enable populations to better target interventions. Four or more ANC visits, institutional delivery and postnatal care follow-ups plays a significant role within the continuum of care and permits more programmatic consideration. Policies and strategies to ensure that vital services are available to all women and implement to awareness women regarding information seeking and benefit of attend antenatal care can diminish the birth complication for the future maternal health.