Quality of maternal and newborn care across the continuum in Ethiopia: the assessment of service contacts, care components, and associated factors

Poor quality care is a major contributor to neonatal and maternal deaths. While achieving high and equitable service coverage is essential, it must be accompanied by the delivery of good-quality care. This study aimed to determine the quality of continuum care at the community level in Ethiopia. The study analyzed data from an end-line population-based implementation survey. We used count data modeling to identify predictors of continuum of care. The final model employed adjusted incidence rate ratios (aIRR) with p-values < 0.05 and 95% CI to determine statistically significant associations. About 39.1% of mothers received quality-adjusted antenatal care (ANC), 18.9% received quality-adjusted peripartum care, and 0.3% of mothers and 0.8% of babies received quality-adjusted postnatal care. The rate of obtaining quality ANC was higher for rich women (aIRR = 1.06; 95% CI: 1.01–1.11), had home visits (aIRR = 1.07; 95% CI: 1.01–1.12), and ready referral system (aIRR = 1.02; 95% CI: 1.01–1.03). Quality peripartum care was positively associated with wealth status (aIRR = 1.17, 95% CI: 1.10–1.24), attending ANC4 + visits (aIRR = 1.10, 95% CI: 1.04–1.16), and using ANC (aIRR = 1.13, 95% CI: 1.06–1.20). Using SFD positively associated with the quality of PNC (aIRR = 1.4, 95% CI: 1.24–1.54) and the mother (aIRR = 1.21, 95% CI: 1.09–1.34). The quality of PNC is associated with referral system readiness (IRR = 1.1, 95% CI: 1.11–1.15). Quality-adjusted coverage along the continuum of care was low. Therefore, efforts should focus on improving the quality of the continuum of maternal health care.