The effect of completion of continuum of maternal healthcare on birth outcomes in Southwest Ethiopia: A prospective follow-up study

There is scarcity of evidence on the effect of completion of maternal healthcare on birth outcomes. Such evidence is essential to prioritize health system interventions to improve perinatal health outcomes. This study was aimed to investigate the effect of the continuum of care completion on birth outcomes in Southwest Ethiopia. We prospectively followed a cohort 987 women in Jimma Zone from pregnancy up to 42 days postpartum. We collected data three times using a pretested interviewer-administered questionnaire. We conducted descriptive statistics, multivariate logistic regression, and propensity score matching models were fitted to identify the determinants of birth outcomes. The overall prevalence of completion of the maternal healthcare continuum and adverse birth outcomes were 16.1 % and 7.2 %, respectively. Being a spouse of a partner who has attended formal education (AOR: 3.73, 95 % CI: 1.65, 8.42), being a spouse of a partner who is a public employee (AOR: 5.33, 95 % CI: 1.03, 27.53), having a small family size (AOR: 6.40, 95 % CI: 2.48, 16.51), being grand multiparous (AOR: 0.18, 95 % CI: 0.07, 0.44), receiving complete service during service contacts (AOR: 3.08, 95 % CI: 1.75, 5.40), receiving advice during the service contacts (AOR: 4.67, 95 % CI: 1.10, 19.92), and having social support (AOR: 2.05, 95 % CI: 1.18, 3.56) were associated with higher odds of favorable birth outcome. There is no statistically significant added benefit of the completion of the continuum of care in improving birth outcomes. A remarkable proportion of pregnancies end up with adverse birth outcomes. The completion of care alone doesn’t lead to better birth outcomes. Having a husband who had formal education and is public employee, receiving a complete service packages and advice during service contacts, having a small family size, and social support were associated with favorable birth outcomes. In addition to increasing the frequency of contacts, there should be improvement in the quality and comprehensiveness of service packages. Further research with a large sample size is needed to precisely determine factors associated with each adverse birth outcomes.