Continuum of Maternal Health Care Services and its impact on Adverse Birth Outcomes in North Shoa Zone: An Application of the Propensity Score Matching Approach

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Abstract Background The World Health Organization (WHO) defined: - low birth weight as a weight at birth less than 2500g. Adverse birth outcomes, low birth weight, and preterm birth, constitute an important danger to public health since they raise the likelihood of future diseases and developmental problems for children as well as fetal health status at birth. The study aimed to investigate propensity score methods for causal inference by removing selection bias from observational studies for adverse birth outcomes. Methods We analyzed quasi-experimental studies for the maternal and neonatal health outcome datasets, including adverse birth outcomes for allocated groups of mothers within the period of time from August 2019 to September 2020. We applied different propensity score algorithms, matching, inverse probability weighting, stratification and overlap weighting for covariate balance between midwives-led continuity care and shared model care for adverse birth outcomes. Results The result of the current investigation indicates that mothers who were provided midwife-led continuity (OR=0.48, 95% CI∶( 0.35, 0.894)) with inverse probability treatment weighting (OR=0.36, 95% CI: (0.19, 0.69)) had significant contribution for the improvement of advance birth outcomes. Conclusion Midwife-led continuity care of mothers had a significant enrollment for improving adverse birth outcomes of newborn babies and the propensity score has only controls for measured covariates, propensity score methods are the most recommended approach to adjust confounding and recover treatment effects.

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