Why do women walk away from maternal health services in Southwest Ethiopia? A qualitative study of caregivers' and clients' perspectives.

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Abstract Background Continuum of care (CoC) CoC for Maternal Health Care (MHC) is continuity of care through pregnancy, childbirth, and after birth as a key strategy in reaching mothers and babies at a crucial time. However, dropout from this basic package and critical for women and their infants’ survival and wellbeing is widespread in Ethiopia. Objective The aim of this study is to explore the underlying reasons why do women walk away from maternal health services in Ethiopia caregivers' and clients' perspectives. Methods Exploratory qualitative study took place at selected health facilities in the Jimma zone in November to December 2020 among purposefully selected key informants from woreda health departments, head of the health facilities, midwives and women attending the MCH clinic based on the established criteria. Data was collected using key informants interview guide Result The field note, interview note, and tape-recorded interviews were transcribed and later translated into English. The main themes were identified and compared across all the transcripts to determine similarities and variations in the views of respondents. Accordingly, the reasons why do women walk away from maternal health services were categorized under three main themes: healthcare system related reasons (shortfall in supplies, missed use of the concept of responsibility and accountability, high staff turnover, poor linkage and COVID_19) ,community level barriers (socio cultural /norm, less attention to forum, weak community level structure) and individual level barriers (Knowledge and sense of fatigue as gestational age advances, late booking for ANC, lack of motivation and socioeconomic).

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