Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013

Objectives To identify factors associated with the continuum of maternal, newborn and child health care in The Gambia. Design A secondary statistical analysis using Demographic and Health Survey conducted in 2013. Setting The Gambia. Participants 1308 married women (or with a partner) whose most recent children were aged 12-23 months at the time of the survey. Outcome measures The main outcome was continuum of care for maternal, newborn and child health. The modified composite coverage index was calculated to express the completion level of continuum of care. Results The following factors were associated with the continuum of maternal, newborn and child health care: women's autonomy in decision-making of her own healthcare (beta=0.063, p=0.015), having higher educated husbands (beta=0.138, p<0.001), listening to the radio at least once a week (beta=0.078, p=0.006), having a child with birth order less than 5 (beta=0.069, p=0.037), initiating the first antenatal care within 16 weeks of pregnancy (beta=0.170, p<0.001), having been informed of signs of pregnancy complications (beta=0.057, p=0.029), living in rural areas (beta=-0.107, p=0.006) and having higher burden due to distance to health facility (beta=-0.100, p<0.001), with an explanatory power of 15.5% (R-2=0.155). Conclusions Efforts on future policies and programmes should focus on the concept of continuum of care considering the associated factors. In particular, more attention should be given to providing country-wide family planning and education to women, men and community members in The Gambia.