Dropout from the maternity continuum of care and its determinants among women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The maternity continuum of care including antenatal care (ANC), skilled birth attendance, and postnatal care is essential for reducing maternal and neonatal morbidity and mortality, yet many women in Ethiopia discontinue care. METHODS: A systematic review and meta-analysis of observational studies was conducted using five databases (Web of Science, Scopus, PubMed, Cochrane Library, and Google Scholar), covering studies published from 1/1/2015- 4/10/2025. A total of six studies involving 3,181 participants were included. A random-effects model was applied, and heterogeneity was assessed using the I2 statistic. Publication bias was evaluated using funnel plot symmetry and Egger's regression test. RESULTS: The pooled prevalence of dropout from the continuum was 61.81% (95% CI: 48.53-75.10), with substantial heterogeneity (I 2 = 100%). Key associated factors included lack of media exposure, unplanned pregnancy, fewer than four ANC visits, rural residence, and limited awareness of maternal health services. Dropout was highest between ANC and skilled birth attendance. CONCLUSION: This review suggests a substantial level of dropout from the maternity continuum of care in Ethiopia. Strengthening health education, improving access to information, promoting adequate ANC visits, and expanding community-based interventions may help improve continuity of maternal care.