IntroductionIntegrated primary health care service provided by skilled birth attendants is linked to safe childbirth and postnatal care, vitally improves maternal, newborn, and child health outcomes. Despite a significant reduction in maternal and neonatal mortality in Ethiopia, low maternal service utilization, and dropout from the maternal continuum of care continues to be a major challenge. Therefore, this study aimed to investigate the individual and community predictors of dropout from the maternal continuum of care in Ethiopia.MethodsWe used data from the 2016 Ethiopian demographic and health survey (EDHS). Women who had a birth in the 5 years preceding the survey were included. Dropout from the maternal continuum of care was the outcome of this study. This includes, attending less than four antenatal care visits (<4 ANC), a dropout from skilled birth attendance (SBA) after having 4 or more ANC, and dropout from postnatal care (PNC) after having SBA. Multilevel logistic regression analysis was employed. The mixed effect and variation in the outcome were expressed by the intracluster correlation coefficient (ICC).ResultsHigher dropouts from SBA to PNC (85%) and from ≥4 ANC to SBA (43.4%) in the maternal continuum of care were observed. Women from the poorest wealth quantile (AOR=2.31,95% CI 1.69,3.16), not covered by health insurance (AOR=1.44, 95% CI, 1.01,2.06), and residing in a community with high poverty (AOR=1.28,95% CI, 1.01,1.63) were more likely to attend inadequate ANC. On the other side, distance from a health facility (AOR=1.45, 95% CI, 1.12,1.88), lower community media exposure (AOR=1.6, 95% CI, 1.14,2.23) and rural residency (AOR=3.03, 95% CI, 1.75,5.26) were associated with dropout from SBA after attending ANC visits. Living in Somali, Harari, and Dire Dawa significantly associated with drop out from the PNC after SBA.ConclusionThe pattern of dropout from the maternal continuum of care was higher in Ethiopia. Maternal education, wealth index, community media exposure, and distance from a health facility were the factors associated with dropouts from the maternal continuum of care. Home care strategies and contextual understanding of the barriers to the PNC service is needed.

Background: The lower priority given for involving male partners in birth preparedness and complication readiness contributes to the poor maternal and neonatal health outcomes. Male partners in low- and middle-income countries determine women’s access to and affordability of health services and directly influence their health outcomes. This systematic review and meta-analysis determine the pooled magnitude of the male partner’s participation in birth preparedness and complication readiness in the global south.Methods: Literature published in the English language from 2004 to 2019 was retrieved using appropriate search terms on Google Scholar, PubMed/MEDLINE, CINHAL, Scopus, and Embase. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. A pooled statistical meta-analysis was conducted using STATA Version 14.0 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test, respectively. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis. The Random effects model was used to estimate the summary prevalence of BPCR and the corresponding 95% confidence intervals (CI). Results: 12 studies and 4210 participants were included. The overall pooled result showed 52.3% of male partners of pregnant women and nursing mothers were prepared for birth and its complications. Forty-nine percent of male partners saved money for delivery and 40.5% of them identified skilled birth attendants, and 55% of male partners saved money for birth or its complication. Only 42.1% of male partners arranged transportation and 59.8% of them identified the place of birth. Only 18.9% of male partners identified a potential blood donor for emergency cases of childbirth and postpartum complication.Conclusions: A low proportion of male partners of pregnant women and nursing mothers were prepared for childbirth and its complications. Countries in the global south region should review their health care policies and design strategies to improve the birth preparedness and complication readiness practice among male partners of pregnant women and nursing mothers.