Abstract:
The uptake of maternal healthcare services remains suboptimal in Ethiopia. Significant proportions
of antenatal care attendees give birth at home in the context of HIV. However, in Ethiopia, evidence is scarce on the
predictors of dropout from maternity continuum of care among HIV-positive mothers. Therefore, this study aimed
to supply valuable information on risk factors regarding dropout of HIV-positive mothers for institutional delivery
services in northwest Ethiopia.
Methods: A multicenter case–control study was conducted at governmental health facilities in Gondar City from
May one to June 30/2018. A total of 222 HIV-positive women were included in the study. Data were collected using
structured questionnaires and checklists through face-to-face interview and chart review; entered into EPI INFO version seven, and then exported to SPSS version 25. Both descriptive and analytical procedures were performed. Binary
logistic regression analysis was undertaken. A significant association was declared based on the adjusted odds ratio
(AOR) with its 95% CI and p-value of≤0.05.
Results: This study illustrates that maternal age of≥35 years (AOR=2.37; 95%CI: 1.13,5.13), unmarried marital relation (AOR=3.28; 95%CI: 1.51, 7.13), unemployed spousal occupation (AOR=3.91; 95%CI: 1.54, 9.91), family monthly
income of≤36 US dollar (AOR=4.87; 95%CI: 2.08, 11.42) and no obstetric complication in the index pregnancy
(AOR=13.89; 95%CI: 2.73, 27.71) were positively associated with dropout from institutional delivery among HIV positive antenatal care booked mothers.
Conclusion: In this study, the risk factors of dropout from institutional delivery in the context of HIV-positive women
were connected to social determinants of health such as advanced maternal age, unmarried marital status, unemployed husband occupation, and low family income. Therefore, interacting with the health system by focusing on
these women in lower socio-economic strata and unmarried HIV-positive ANC attendees, and increasing access to
information on obstetric complications during the antenatal care visit would retain clients in the continuum of maternity services.
