Maternal and community factors associated with postnatal care checkups in Ethiopia: A multi-level analysis

Abstract

Background Maternal mortality remained a public health issue, especially in developing countries. Although the first two days after birth was a critical time in which the highest maternal death recorded, it was the most neglected period of maternal health services. Therefore, this study aims to determine the maternal and community-level factors of postnatal check-ups in Ethiopia Methods Demographic and Health Survey (DHS) in 2016 was utilized. A total of 3,948 women aged 15-49 giving birth in the two years before the survey were included. The response variables were post-natal check-ups in the first two days after birth, dichotomized into no check-ups in the first two days and check-ups within two days after giving birth. The explanatory variables were individual maternal characteristics such as education, household wealth, perceived distance to a health facility to get medical help, employment status, antenatal care (ANC), delivery by cesarean section, birth order and place of delivery, and selected community characteristics such as community literacy, community socioeconomic status, community ANC coverage, community perception of distance to a health facility, and regional states. A multi-level mixed-effects logistic regression model was employed. Result Only 17% of the women had a postnatal check-up within 2 days of giving birth in Ethiopia. Institutional delivery AOR 2.14 [95% C.I 1.70, 2.0] and giving birth by cesarean section AOR 1.66 [95% CI 1.10, 2.50] were found to be maternal factors, whereas administrative regions(Oromia 69%, Somali 56%, Benishangul 55%, SNNPR 43%, Gambela 66%, Afar 50% and Dire Dawa 55% which less likely to utilize postnatal care utilization as compared to Addis Ababa city administrative area), Higher community-level wealth AOR 1.44 [95% C.I 1.08, 1.2], ANC coverage AOR 1.52 [95% C.I 1.19, 1.96] and perceived distance of the health facility as a big problem AOR 0.78[95% C.I 0.60, 0.99] were the community factors associated with postnatal check-ups in Ethiopia. Conclusion Both maternal factors and community factors are found to be a significant association with postnatal care services utilization, however, based on the ICC maternal factors prevail the community-level factors. Increasing access to postnatal care services to the remote areas of Ethiopia was recommended.

Spatial distribution and determinants of newbornsnot receiving postnatal check-up withintwodays after birth in Ethiopia: a spatial and multilevel analysis of EDHS 2016

“…The overall national prevalence of newborns not receiving postnatal check-ups within 2 days after birth in Ethiopia was 84.29, 95% CI: (83.11-85.41), which is in line with the study conducted in Ethiopia 83% [23]. However, the finding of our study was slightly lower than those of the study conducted in rural Bangladesh at 90%, and in Ethiopia at 90% [5,24].…”

Trends and factors associated with immediate postnatal care utilisation in Ethiopia: analysis of the demographic and health surveys, 2011-2019

“…This result is in line with studies conducted in Ethiopia, Uganda, Sierra Leone, and Malawi. 31,33,35,37,39,40 Women who give birth by caesarean section are at higher risk of short and long-term complications compared to vaginal birth, and require specific packages of care including ambulation, checking wound healing and monitoring for infection. 46 For this reason, health professionals might give more attention to these women.…”

“…Existing published literature on postnatal care utilisation from low-and middle-income countries (LMICs) were reviewed. [30][31][32][33][34][35][36][37][38][39][40] Variables that had a significant association in previous studies and are available in the 2019 EDHS data set were included as independent variables in the analysis. These variables were categorized into socio-demographic and reproductive factors.…”