The Level of Completion of Continuum Maternity Care and the Associated Factors in the pastoralist and non-pastoralist districts: comparative cross-sectional study

Abstract Background Utilization of continuous maternal health care is key to preventing maternal morbidity and mortality. Although completion of continuous maternal care (COCMC) plays a crucial role, the level of utilization of continuous maternal care is low, but the reasons for this seem unclear. Therefore, this study aimed to determine the level and factors associated with COCMC in pastoralist and non-pastoralist districts of Ari and South Omo zones in 2024. Methods A community-based comparative cross-sectional study was conducted from March to May 2024. A multistage sampling procedure was used to select 632 study participants (270 from agricultural and 362 from pastoralist districts). Data were collected using a standard questionnaire completed by an interviewer via the Kobo toolbox and exported to the Statistical Package for Social Science-26 (SPSS-26) for analysis. A multivariable logistic regression model was created to identify factors associated with the level of COCMC. The results were presented in the form of frequencies and adjusted odds ratios with their respective 95% confidence intervals. Statistical significance was determined at a p-value of less than 0.05. Results The overall level of COCMC was 46(7.3%; 95%CI: 5.3%-9.3%), and there was no significant difference between pastoralist and agricultural districts in terms of COCMC level; 27(7.4%) and 19(7.0%), respectively. COCMC was associated with living in an urban area (AOR: 2.52[1.10–5.90]), mother's decision-making power to use household resources for maternal health care (AOR: 2.62[1.25–5.48]), lack of home-to-home healthcare by health worker (AOR: 0.31[0.14–0.69]), and living in the poorest household (AOR: 0.21[0.10–0.96]). Conclusion and recommendations The level of COCMC is very low in the study area, and to improve it, giving special attention to rural communities of the agrarian and pastoralist areas, enhancing maternal decision-making power on domestic resources, strengthening integrated home-to-home maternal healthcare service by a health worker and enhancing economy of households are all recommended.