Understanding the Context and Determinants of Dropout from Maternity Continuum of Care in South Asia: Based on Andersen Behavioural Model

Subhojit Let

This study aims to assess dropout rates from the Maternal Continuum of Care (CoC) in South Asia, focusing on mothers with four or more antenatal care (ANC) visits, delivery by a skilled birth attendant (SBA), and postnatal checks by skilled health workers within 48 hours. Using data from the latest Demographic and Health Surveys (DHS) in Bangladesh, India, Nepal, and Pakistan, with a sample size of 188,849 mothers aged 15-49, the study found an average dropout rate of 51.2% in South Asia, with notable country-level differences. Bangladesh had the highest dropout rate at 68.3%, while Nepal had the lowest at 41.8%. Dropout rates were notably higher among mothers with no education and those from poor households. Pro-poor inequality was evident in all countries, with Pakistan exhibiting the highest inequality (ECI: -0.519, p<0.001). Key factors influencing dropout rates included education, parity, household wealth, and place of residence. In Bangladesh and Pakistan, uneducated mothers and those from the poorest households had the highest dropout odds. In India and Nepal, poor women and those with low mass media exposure were more likely to drop out. These disparities highlight the urgent need for targeted interventions to address barriers in maternal healthcare.

Keywords: Population and Development, Sexual and Reproductive Health and Rights, Inequality, Disadvantage and Discrimination, Fertility

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