Postnatal care could be the key to improving the continuum of care in maternal and child health in Ratanakiri, Cambodia

Abstract

In South-East Asia, the maternal and child mortality rate has declined over the past decades; however, it varies among and within the countries in the region, including Cambodia. The continuum of care is an integrated series of care that women and children are required to avail continuously from pregnancy to the child/motherhood period. This study aimed to assess the completion rate of the continuum of care and examine the factors associated with the continuum of care in Ratanakiri, Cambodia. A cross-sectional study was conducted in Ratanakiri. Overall, 377 women were included, and data were collected via face-to-face interviews using a semi-structured questionnaire. Among them, 5.0% completed the continuum of care (antenatal care at least four times, delivery by skilled birth attendant, and postnatal care at least once). Meanwhile, 18.8% did not receive any care during pregnancy, delivery, and after birth. The highest discontinuation rate was at the postnatal care stage (73.6%). Not receiving any perinatal care was associated with neonatal complications at 6 weeks after birth (adjusted odds ratio [AOR]: 3.075; 95% confidence interval [CI]: 1.310–7.215). Furthermore, a long distance to the health center was negatively associated with completion of the continuum of care (AOR: 0.877; 95% CI: 0.791–0.972). This study indicates the need for efforts to reduce the number of women who discontinue from the continuum of care, as well as who do not receive any care to avoid neonatal complications. Since the discontinuation rate was highest at the postnatal care, postnatal care needs to be promoted more through the antenatal care and delivery services. Furthermore, given that long distance to health facilities was a barrier for receiving the care continuously, our findings suggest the need for a village-based health care system that can provide the basic continuum of care in remote areas.

Level of completion along continuum of care for maternal and child health services and factors associated with it among women in Arba Minch Zuria Woreda, Gamo Zone, Southern Ethiopia: a community based cross-sectional study

“…In this study the level of continuum of care was 9.7%[95% CI: 6.9%, 12.5%] which is consistent with findings from study in Tanzania (10%) [17] but higher than study conducted in Cambodia (5%) [23], and lower than studies conducted in Pakistan (27%) and Egypt (50.3%) [21,22]. The possible reason in this study might be due to time variation, variation in study design, and variation in source of data.…”

“…Women were classified as not completed the continuum of care if they missed any one of the above visits/attendances at any level. [17,[21][22][23].…”

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

“…It is an essential element across the continuum of care in the maternal and child health care services, and serve as a gateway for family planning services. Woman and her partner/family require more information than they usually receive on the care of the baby and mother within the rst week after childbirth, to stay safe from maternal and neonatal complications [5].…”

Impact of Health Care Delivery Utilization on Under-5 Child Mortality in Myanmar

“…Otherwise, the reason will be the need to the improved skilled worker and health awareness. This study found that postnatal care was significantly negative associated with improving the continuum of care maternal and child health in Ratanakiri, Cambodia [15]. Skilled delivery of essential maternal and perinatal care practices that to reduce maternal and new-born injury [16].…”