Barriers and facilitators to engage with the maternity continuum of care in northwest Ethiopia: a qualitative descriptive study

AIM: Globally, women's engagement with the maternity continuum of care throughout pregnancy, childbirth, and the postpartum period helps reduce maternal and newborn deaths. However, women's engagement with the maternity continuum of care remains low in Ethiopia, and the underlying reasons are not yet well understood. This study aimed to explore the facilitators and barriers influencing women's engagement with the maternity continuum of care in northwest Ethiopia. METHODS: A qualitative descriptive approach was employed. Fifteen postpartum women and six healthcare workers were purposively selected and interviewed to gather diverse perspectives. Following consent, interviews were audio recorded, transcribed in Amharic, and then translated into English. Data were analysed using Braun and Clarke's reflexive thematic analysis using NVivo 15. FINDINGS: Key barriers to engaging with the maternity continuum of care included limited awareness and low health literacy, difficulties in accessing and receiving care, lack of social and community support, and restrictive cultural and traditional practices. Facilitators included having awareness of maternity care and understanding of maternity care benefits, improved access to maternity services, strong support from family and social networks, and the availability of community health initiatives. CONCLUSIONS: Multiple barriers affect women's engagement with the maternity continuum of care. Interventions such as health education should focus on increasing awareness among women and communities about the maternity continuum of care, supporting women, and promoting positive changes within cultural norms and traditions. Strong commitment from both government and healthcare providers is essential to improve service accessibility and ensure respectful maternity care.