Background Postnatal care (PNC) service is a neglected yet an essential service that can reduce maternal, neonatal and infant morbidity and mortality rates in low and middle-income countries. In Malawi, maternal and infant mortality rates remain high despite numerous efforts by the government and its partners to improve maternal health service coverage across the country. This study examined the determinants of PNC utilization among mothers in Mangochi District, Malawi. Methods A community based cross-sectional study was conducted among 600 mothers who gave birth in the past 2 years preceding January 1–31; 2016. A multistage sampling technique was employed to select respondents from nine randomly selected villages in Mangochi district. A transcribed semi-structured questionnaire was pre-tested, modified and used to collect data on socio-demographic characteristics and maternal related factors. Data was coded in EpiData version 3.1 and analysed in Stata version 12. A multivariable logistic regression adjusted for confounding factors was used to identify predictors of PNC utilization using odds ratio with 95% confidence interval and p-value of 0.05. Results The study revealed that the prevalence of PNC service utilization was 84.8%. Mother’s and partner’s secondary education level and above (AOR = 2.42, CI: 1.97–6.04; AOR = 1.45, CI: 1.25–2.49), partner’s occupation in civil service and business (AOR = 3.17, CI: 1.25, 8.01; AOR =3.39, CI:1.40–8.18), household income of at least MK50, 000 (AOR = 14.41, CI: 5.90–35.16), joint decision making (AOR = 2.27, CI: 1.13, 4.57), knowledge of the available PNC services (AOR = 4.06, CI: 2.22–7.41), knowledge of at least one postpartum danger sign (AOR = 4.00, CI: 2.09, 7.50), health facility delivery of last pregnancy (AOR = 6.88, CI: 3.35, 14.14) positively associated with PNC service utilization. Conclusion The rate of PNC service utilization among mothers was 85%. The uptake of PNC services among mothers was mainly influenced by mother and partner education level, occupation status of the partner, household income, decision making power, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore, PNC awareness campaigns, training and economic empowerment programs targeting mothers who delivered at home with primary education background and low economic status are needed.

BackgroundPostnatal care (PNC) services such as antenatal care, labour and delivery care services are paramount in maternal, neonatal morbidity and mortality rates reduction in low and middle income countries. Several factors impede the effective utilization of these services by mothers which makes them access few services than recommended by world health organization. This study examined the determinants of PNC utilization among mothers in Mangochi District, Malawi.MethodsA community based cross-sectional study involving a multistage sampling of 600 mothers from nine randomly selected villages in Mangochi district, Malawi was conducted in the month of January, 2016. A transcribed semi-structured questionnaire was pre-tested, modified and used to collect data on socio demographic, socio-economic and socio-cultural characteristics. A Pearson Chi square (𝜒2) test was used to determine the association between the socio-demographic, socio-cultural, and socio-economic factors and PNC utilization. A multivariable logistic regression with 95% confidence interval was performed to determine the predictors of PNC service utilization.Results84.8% of the mothers utilized PNC services at least once within the postnatal period. Among the PNC users, 74.5% attended once, 20% attended two to three times and 5.5% attended more than three times. The predictors of PNC service utilization were education level of the mother (AOR= 2.42, CI: 1.97-6.04) education level of the partner (AOR=1.5, CI: 1.25-2.49) , occupation status of the partner (AOR= 3.2, CI: 1.25-8.01), household level of income (AOR=14.4, CI: 5.90-35.16), decision making (AOR=2.27, CI: 1.13-4.57), knowledge of available PNC services (AOR=4.2, CI: 2.22-7.41), knowledge of at least one postpartum danger signs (AOR=4.0, CI:2.07-7.50), and place of delivery (AOR=6.9, CI: 3.35-14.14).ConclusionThe rate of PNC service utilization among mothers was 85%. The uptake of PNC services among mothers was mainly influenced by education level of the mother and partner, occupation status of the partner, household level of income, decision making power, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore, reinforcement of the existing policies and strategies to increase awareness about PNC services among mothers through awareness campaigns, training and empowerment programs is needed.

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The index case of COVID-19 in Uganda was reported on 20th March 2020. The first confirmed imported case of COVID-19 in Kigezi sub- region South Western Uganda, where Kabale University is located, was reported on April 24th 2020. On August 2nd 2020 the first COVID-19 community case was recorded in the Kigezi Sub-region. Right from the early days of the threat of COVID-19 spread in Uganda, Kabale University put in place multiple mechanisms and interventions to contain the pandemic including: A COVID-19 Study Group: set up in February 2020 to study the disease, carry out risk assessment and advise the University on how to be prepared to handle cases if the disease were to reach the environment of the University. A multidisciplinary Kabale University COVID-19 Task Force: set up on 30th March 2020 to advise the University on preparations to ensure safe continuity of business at the university during a possible outbreak of COVID-2019 by designing and implementing appropriate infection prevention and control (IPC) measures, the Standard Operating Procedures (SOPs), for the University community. COVID-19 Knowledge Attitudes & Practice (KAP) Study –to inform planning for safe maintenance of business continuity at the university in the face of the COVID-19 outbreak. Following a national lockdown, the purpose of the study was to guide development of necessary measures to be undertaken to minimize the spread of COVID-19 among students, staff and visitors when re-opening of the University became imminent. The study revealed high levels of knowledge (84% correct rate of response); an overall positive attitude (77% positive rate of response); but only moderate COVID-19 preventive practices (68.8% correct rate of preventive practice). Knowledge was higher among male students (p=0.033); students older than 20 years (p=0.000); and students taking health related courses such as Medicine or Nursing (p=0.019). Attitudes about COVID-19 were better among female students (p=0.034); and in students older than 20 years (p=0.000). Age and sex are significant predictors of COVID-19 prevention practices (p=0.001, p=0.000 respectively). These findings informed the need for: Effective behavioral change communication: to alert the university and the neighboring communities about COVID-19. The strategies to be used to achieve this were; Internal memos to the university community through e-mail, social media and written notices placed in strategic areas, Radio talk shows through several FM radio stations in Kabale town and, Branded health literacy print-outs in form of posters, leaflets and brochures. Promotion of good respiratory and oral and hand hygiene – to discourage; haphazard spitting, ejecting or smearing nasal mucus on public places, sneezing or coughing in public without protection, and promotion of frequent handwashing. Random COVID-19 testing – One such test in June 2021 revealed positivity rate of 17.8% Development of the Kabale University COVID-19 Standard Operating Procedures. The order of personal prevention priorities emphasized in the SOPs were; face masking, hand washing with running water and soap or disinfectant, hand sanitizing with 70% alcohol and, keeping a physical distance of at least 2 meters from one another etc. With vaccination, this order has now been revised to give top priority to vaccination, although we still equally emphasize maintenance of the previous strategies.