Regional and System Barriers

Amhara, Oromia, and SNNP had lower CCI scores than Addis Ababa at various quantiles. Regional gaps may reflect economic, infrastructure, staffing, service-quality, budgetary, socioeconomic, and cultural differences. The study identified substantial gaps in ANC4, skilled birth attendance, immediate postnatal care, and childhood immunisation. Incomplete care is linked to socioeconomic, geographic, cultural, infrastructure, logistics, and workforce barriers. Internal conflict disrupted Ethiopian health systems and caused women and children to drop out of the continuum. COVID-19 reduced use of maternal and child health services and contributed to low coverage. Policy priorities include infrastructure, health workforce, supplies, women's literacy, ANC, maternity waiting homes, partner involvement, and targeted support for disadvantaged groups.