Level of completion of maternity continuum of care among ever-married women: An analysis of Somalia's health and demographic survey 2020.

INTRODUCTION

Somalia is continuing to recover from three decades of underdevelopment, political instability, civil unrest, and protracted humanitarian crises. However, Somalia has one of the lowest maternal health indicators in the world. For instance, the maternal mortality ratio is 621 per 100,000 live births. Extra efforts are needed to improve maternal health. In this study, we aim to investigate the level of completion and coverage along the maternity continuum of care in Somalia.

METHOD

The study used data from the 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). Completion of the continuum of maternity care was the outcome variable for this study. It was constructed into a binary variable with complete coded as one and incomplete coded as 0. We categorized it into three models: ANC4+ as the first model, ANC4+ & SBA as the second model, and ANC4+ & SBA & PNC as the third model.

RESULTS

More than half of the women (53.1%) had their most recent births at ≤19 years old. Of all the mothers (n = 2432), only 235 (9.7%) had at least four or more of the recommended antenatal care (ANC4+), and 68 (2.8%) of them utilized skilled birth attendants. Only 14 (0.6%) women received all three maternal healthcare services (ANC4+, SBA, and PNC within 48 hours). 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 strategies to improve maternal healthcare utilization specific to rural and nomads, less educated, not working, low income, and have less power in decision-making.