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. 2025 Sep;51(5):e70151.
doi: 10.1111/cch.70151.

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

Birye Dessalegn Mekonnen  1   2 , Vidanka Vasilevski  1   3 , Ayele Geleto Bali  1 , Linda Sweet  1   3
Affiliations

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

Birye Dessalegn Mekonnen et al. Child Care Health Dev. 2025 Sep.

Abstract

Background: Completion 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.

Methods: The 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.

Results: Women 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).

Conclusion: Pregnancy 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.

Keywords: Ethiopia; breastfeeding; essential newborn care; immunisation; intended pregnancy; unintended pregnancy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of participant's progress through the PMA cohort study.
FIGURE 2
FIGURE 2
Balance of propensity score before and after weighting across intended and unintended pregnancies (essential newborn care practices).
FIGURE 3
FIGURE 3
Balance of propensity score before and after weighting across intended and unintended pregnancies (early initiation of breastfeeding).
FIGURE 4
FIGURE 4
Balance of propensity score before and after weighting across intended and unintended pregnancies (exclusive breastfeeding).
FIGURE 5
FIGURE 5
Balance of propensity score before and after weighting across intended and unintended pregnancies (full infant immunisation).
See this image and copyright information in PMC

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