Maternal and Neonatal Health in Conflict-Affected Areas of West Gojjam Zone, Northwest Ethiopia

Abstract Background: Maternal and neonatal mortality remain major global public health challenges, particularly in low- and middle-income countries. Progress in reducing these deaths has slowed, while armed conflict further worsens outcomes by disrupting healthcare services and access to essential maternal care. Therefore, this study assessed maternal and neonatal health outcomes and associated factors in conflict-affected areas of West Gojjam Zone, Northwest Ethiopia. Objective: To Assess Maternal and Neonatal Health in Conflict-Affected Areas of West Gojjam Zone, Northwest Ethiopia. Methods: A facility-based cross-sectional study was conducted among 418 pregnant women attending antenatal care services from October 1 to May 12, 2025. Participants were selected using a systematic sampling technique. Data were collected using interviewer-administered, semi-structured questionnaires, entered into EpiData version 3.1, and analyzed using Stata version 17. Variables with a p-value ≤ 0.25 in the bivariable analysis were included in the multivariable logistic regression model, and statistical significance was determined at p < 0.05. Results: Assisted vaginal delivery (AOR: 0.19, 95% CI: 0.12–0.28) and cesarean section (AOR: 0.29, 95% CI: 0.16–0.51) were protective against low birth weight compared to spontaneous vaginal delivery. Severe maternal anemia (Hb <7 g/dl) (AOR: 2.17, 95% CI: 1.51–3.10), vaginal bleeding during pregnancy (AOR: 2.44, 95% CI: 1.69–3.51), ICU admission (AOR: 2.28, 95% CI: 1.58–3.29), and personal safety problems (AOR: 2.14, 95% CI: 1.13–4.08) significantly increased the risk of low birth weight. Experiencing family member death reduced the odds of low birth weight (AOR: 0.46, 95% CI: 0.24–0.90). Conclusion and Recommendations : Adverse neonatal outcomes were high in the study area, driven by obstetric, nutritional, medical, and conflict-related psychosocial factors. Strengthening emergency obstetric and neonatal care, improving maternal nutrition, enhancing antenatal services, and integrating psychosocial support are essential to improve outcomes in conflict-affected setting