Knowledge, views and practices of mothers regarding postnatal care at Zomba Central Hospital, Malawi

Abstract

Background: Two thirds of all women who deliver in an urban hospital in Malawi do not return for postnatal care at 1 and 6 weeks after labour. Factors that influence their postnatal visit are not well established. Aim: This study investigates factors influencing the attendance at postnatal visits at 1 and 6 weeks among mothers at Zomba Central Hospital in Malawi. Specifically, the study assessed mothers' knowledge about postnatal care at 1 week and 6 weeks, and determined the characteristics of mothers who did or did not attend postnatal appointments on these dates. Method: A descriptive quantitative, cross-sectional study was conducted to assess mothers' knowledge. Data were collected using a structured interview. A convenient sample of 154 mothers participated in the study. Ethical approval was obtained from the Malawi College of Medicine Ethical Review Board. Data were analysed using SPSS. Findings: A sample of 154 mothers participated in the study who were all attendees at an under-fives clinic and had infants who were between 8 weeks and 12 months old. More than 75% of participants were aged between 20 and 30 years old. The main factor that hindered attendance was lack of advice given by midwives to return for postnatal care. Awareness of postnatal services, mothers' educational level and growth monitoring all promoted utilisation of postnatal care at 1 and 6 weeks. These findings have implications for training and practice: training institutions should emphasise the importance of postnatal care at 1 and 6 weeks; and, with reference to practice, supervisors of midwives should ensure that mothers are booked for postnatal care at 1 week and 6 weeks.

Household factors associated with use of postnatal care services

“…The opposite was found to be true for single women or women in polygamous marriages, who lacked financial and partner support and had difficulties in attending postnatal care services. Having more children also increased constraints on family resources and so multiparous women were found to be more unlikely to use postnatal care services (Rahman et al, 2011;Sakala, 2013;Mohan et al, 2015;Ayanore et al, 2016;Rwabufigiri et al, 2016;Bobo et al, 2017;Tiwari, 2017). Similar findings have also been recorded on background characteristics a study from Africa (Ayanore et al, 2016).…”

“…Awareness and knowledge of postnatal care services was found to positively influence uptake (Titaley et al, 2010;Rahman et al, 2011;Sakala, 2013;Katushime and Katushabe, 2014;Essendi et al, 2015;Lindquist et al, 2015;Mohan et al, 2015;Tiwari et al, 2017). Women who belonged to households that were exposed to the media (Rahman et al, 2011) and whose husbands attended health facilities for HIV testing were more likely to attend postnatal services as they were encouraged and supported by their husbands and family members (Mohan et al, 2012).…”

“…In Rwanda, the practice of Kwita Izina discourages mother and neonate from leaving the house before the eighth day, when the baby is given a name (Rwabufigiri et al, 2016). Sakala (2013) showed that mothers were advised by their elders to use local herbs during the postnatal period, both for themselves and to apply on the umbilical cord of the neonates to hasten healing and provide protection from sorcerers. In rural Tanzania, mothers were encouraged by family members to use traditional birth attendants, who provided care and follow-up rituals for women and babies (Mahiti et al, 2015).…”

Factors Influencing Women’s Attendance to Postnatal Clinics in the Primary Healthcare Centers in the Kingdom of Bahrain, 2023

“…This study showed that there is a significant statistical association between attendance at the PNC and the information provided by healthcare workers about the importance of the PNC (p < 0.05), the services provided in the clinic (p < 0.03), and the booking process (p < 0.001). These findings are similar to those found in studies conducted in Malawi [ 34 , 36 ], Zaria-Nigeria [ 38 ], and Nepal [ 43 ].…”

“…This study showed no significant association between PNC attendance and the age of the mother, in contrast to what was found in studies in Hawassa Zuria, which showed that the use of PNC services was higher in those under the age of 25 years [ 28 ], and in Sub-Saharan Africa, where underutilization of PNC services was high among the young age group [ 31 ]. Also, there was no significant association between PNC attendance and the educational level of both partners and the employment status of the mother, unlike what was found in Ethiopia [ 33 ], Malawi [ 36 ], Nepal [ 37 ], and Nigeria [ 38 ], where mothers who attended college or had higher education were more likely to use PNC services compared to women with primary education or no formal education. Moreover, employed women had higher PNC service attendance than the unemployed in Sub-Saharan Africa [ 31 ], Abia State [ 35 ], and Nigeria [ 38 ].…”