Level of Completion of Maternity Continuum of Care among ever-married women: An analysis of Somalia Health and Demographic Survey 2020

Abstract

Introduction Somalia has one of the worst maternal conditions in the world with maternal mortality ratio of 692 per 100,000 live births. For every maternal death, over 100 women suffer a severe obstetric morbidity. However, most of the maternal morbidity and mortality in Somalia are preventable through access to high quality care in pregnancy, and during and after childbirth. The aim of this study is to investigate the coverage and the level of completion of continuum of maternity care in Somalia. Method The study used a representative data from Somalia Health and Demographic Survey 2020. We restricted our analysis to ever-married women who had a live birth in the five years preceding the survey (n = 2432). The outcome variable was the completion of the continuum of maternity care (CoC). A binary variable was constructed with ‘completed CoC’ coded as ‘1’ and ‘not completed’ coded as ‘0’. We analyzed the data using descriptive analyses. Results More than half of the women (53.1%) had their most recent births at the age ≤ 19 years old. Of all the mothers (n = 2432), only 235 (9.7%) had at least four or more of the recommended antenatal care of four and above (ANC4+), 68 (2.8%) of them utilized skilled birth attendants (SBA) and 2.7% have received postnatal care (PNC) within 48hrs. In total, only 0.6% (N = 14) of the women had received all of the three maternal healthcare services (ANC4+, SBA, and PNC with in 48hrs). About 78.1% of the mothers did not attend any of the three CoC services. Conclusion Maternal health care utilization decreases as they progress from ANC4 + to PNC utilization. The government and partners should design and implement a tailored strategy to improve access and utilization of maternal healthcare services with special attention to rural and nomadic populations.