BackgroundAntenatal care provides the best opportunity to promote maternal and child health services use. But many Ethiopian mothers deliver at home and fail to attend postnatal care. Therefore, this study was done to identify factors associated with health facility delivery among mothers who attended four or more antenatal care visits. The study was also intended to identify factors associated with postnatal care service use among mothers who delivered at home after four or more antenatal care visits.MethodsThis study used the 2016 Ethiopian Demographic and Health Survey data. Two thousand four hundred fifteen women who attended four or more antenatal care visits were included to identify factors associated with health facility delivery after four or more antenatal care visits. Among them, 1055 mothers delivered at home. These women were included to identify factors associated with postnatal care service use. Stata 15.1 was used to analyze the data. Multivariable logistic regression model was fitted to identify associations between the outcome and predictor variables.ResultsAmong women who had four or more antenatal care visits, 56% delivered at health facility. Mothers with secondary or higher level of education (AOR = 2.9; 95% CI = 1.6–5.3), urban residents (AOR = 3.4; 95% CI = 1.9–6.1), women with highest wealth quintile (AOR = 2.7; 95% CI = 1.5–4.8), and working women (AOR = 1.6; 95% CI = 1.2–2.3) had higher odds of delivering at health facilities. High birth order (AOR = 0.5; 95% CI = 0.3–0.7) was negatively associated with a lower likelihood of health facility delivery. Among women who delivered at home, only 8% received postnatal care within 42 days after delivery. Only the content of care received during antenatal care visits (AOR = 1.40; 95% CI = 1.1–1.8) was significantly associated with postnatal care attendance.ConclusionWomen with lower socio-economic status had lower odds of giving birth at health facility even after attending antenatal care. The more antenatal care components a mother received, the higher her probability of delivering at health facility. Similarly, postnatal care attendance was higher among women who had received more antenatal care components.

Key words: antenatal care, facility delivery, postnatal care, quality of care, EDHS, Ethiopia

Background The postpartum period, known as Aras bét in Amharic, has been given little research, practice, and policy attention in Ethiopia.Objective This study examined the dimensions and determinants of postpartum women health-promoting behaviors in Bahir Dar city, Ethiopia.Method A facility-based cross-sectional study design was employed. Using the Health Promoting Life Profile (HPLP) Questionnaire, quantitative data were drawn from 178 randomly selected mothers who had attended at least one postnatal care visit. Data was analyzed using descriptive and inferential statistics.Results Postpartum women reported moderate levels of overall health-promoting behavior (M=141.62; SD=22.44). Across the subscales, spiritual growth (M= 28.81; SD, 5.35) and physical activity (M=18.16; SD=4.49) showed the highest and the lowest average HPLP score respectively. The t-test and ANOVA results showed that health-promoting behaviors varied across various sociodemographic variables such as religion groups, educational level, number of pregnancies, family type, employment status, monthly income, delivery place, delivery type, ANC and PNC attendance (p<0.05). In the binary logistic regression model, postpartum women who had no schooling were 16% less likely to have “better” overall HPLP-II score as compared to their college/university graduated counterparts ( p <0.05).Implications and Conclusion This study differentiated the dimensions and determinants of postpartum health-promoting behaviors. The study offers implications for social and health service providers and future researchers to consider the holistic dimensions of health promotion during the continuum of care for pregnancy.