INTRODUCTION:
Maternal mortality and morbidity challenge low- and middle-income countries. For women living in hard-to-reach areas Community-based maternal health care is a strategy. However, the effect of community health care received from the community health workers on skilled maternal health care utilization was not documented. Identifying its effect helps the policymakers to design appropriate intervention to reduce maternal mortality.

OBJECTIVE:
To identify maternal health care received community health workers among mothers who gave birth in the last year in rural Sidama Regional State from March 2022 to March 2023

METHODS:
We conducted a cross-sectional study among 1821 women who gave birth in the last year. Data was collected from 40 randomly selected villages. A face-to-face interview using a KoboCollect tool was conducted at the women's home. Descriptive analyses of maternal health care received from community health workers were reported by number and percent. Multilevel analysis was used to see the effect of community health worker-related variables on maternal health care utilization. Strength of association was reported by adjusted odds ratio with a 95% confidence interval.

RESULTS:
out of 1821 women interviewed, 1,374 (75%) received community-based antenatal care, and 1,108 (61%) were visited by community health workers during the postnatal period. Women to whom the influential elderly religious leaders have a role in her ANC care [AOR=2.62 (95% CI=1.41-4.86)], receiving antenatal care from health extension workers at women's forums (AOR=2.30 with (95% CI=1.15, 4.67)), and early initiation of ANC (AOR=2.33, with 95% CI=1.38-3.94) are more likely to attend four or more antenatal care sessions than their counterparts.

CONCLUSIONS:
A substantial amount of community-based maternal health services was delivered for rural mothers by health extension workers. Intervention involving influential community members was recommended.