Determinants of antenatal care dropout in South Mecha woreda, Amhara regional state, North west Ethiopia, 2024.

Background: Antenatal care (ANC) is vital for the health and well-being of mothers and their babies during pregnancy. It provides care, education, counseling, screening, and treatment to manage pregnancy-related complications. However, many pregnant women, especially in low-income regions like sub-Saharan Africa, do not complete recommended visits, leading to high dropout rates. Ethiopia, following WHO 2016 recommendations, has adopted an eight-contact ANC model, but still faces a 30% dropout rate. Effective ANC is crucial for reducing maternal mortality rates and ensuring positive pregnancy outcomes.

Objectives: The aim of the study is to identify the determinants of ANC dropout among mothers who delivered in South Mecha Woreda, North West Ethiopia, 2024.

Design: A community-based unmatched case-control study design was employed.

Methods: Study conducted from May 25 to June 25, 2024, using a structured and pre-tested interviewer-administered questionnaire. The final sample included 111 cases and 215 controls, totaling 326 participants. Participants were selected based on the outcome variable of ANC visit dropout (mothers who did not complete the recommended four visits during pregnancy) and ANC visit completion, identified through simple random sampling. Bivariable and multivariable analyses were performed, with a 95% confidence interval (CI) and p-value used to determine significance.

Results: Women who could not read and write had higher likelihood of ANC drop out (adjusted odds ratio (AOR) = 6.475; 95% CI: 2.662, 13.747; p < 0.001), women from families with a monthly income of less than 3000 (AOR = 2.036; 95% CI: 1.666, 6.221; p = 0.012), women who waited more than 30 min (AOR = 5.132; 95% CI: 3.352, 12.877; p < 0.001), and dissatisfaction with the service received (AOR = 5.397; 95% CI: 1.406, 10.719; p = 0.014).

Conclusion: The research indicates that variables like educational level, family income, service waiting times, and satisfaction with services are significant determinants of ANC dropout rates among women in South Mecha Woreda. Women with lower levels of education and income are at a higher risk of dropping out, highlighting the necessity for focused interventions. The research underscores the need for holistic strategies to enhance maternal health and decrease ANC dropout rates.