Effect of Maternal Pregnancy Intention on Neonatal and Infant Healthcare Across the Continuum of Care in Ethiopia: A National Longitudinal Study Using Propensity Score Methods

ABSTRACTBackgroundCompletion of the newborn and infant healthcare practices across the continuum of care, including essential newborn care, exclusive breastfeeding from birth to 6 months of age and immunisation, remains low in Ethiopia. Therefore, this study aimed to determine the impact of maternal pregnancy intention on the newborn and infant continuum of care in Ethiopia.MethodsThe analysis used data from the Performance Monitoring for Action Ethiopia longitudinal survey. This nationally representative survey was conducted from 2019 to 2021. The impact of maternal pregnancy intention on the newborn and infant continuum of care was assessed using propensity score methods. Essential newborn and infant care practices were examined as outcome variables, with pregnancy intention as the exposure variable. Adjusting for potential covariates, the impact of exposure on outcomes was determined using a logistic regression model with an odds ratio at 95% CI based on the inverse probability of treatment weights.ResultsWomen with intended pregnancies had 28% higher odds of early initiation of breastfeeding (AOR = 1.28, 95% CI: 1.03–1.59) and 34% higher odds of exclusive breastfeeding from birth to 6 months of age (AOR = 1.34, 95% CI: 1.08–1.66) compared with women with unintended pregnancies. Similarly, the odds of full infant immunisation were 39% higher among women with intended pregnancies compared with women with unintended pregnancies (AOR = 1.39, 95% CI: 1.03–1.87). However, there was no statistically significant difference in the odds of essential newborn care practices between women with intended and unintended pregnancies (AOR = 0.83, 95% CI: 0.53–1.31).ConclusionPregnancy intention significantly impacts the newborn and infant healthcare practices across the continuum of care. Therefore, prioritising interventions for preventing unintended pregnancies by providing family planning services, early identification of women with unintended pregnancies and ensuring they receive appropriate healthcare services is essential.