Postnatal care for newborns in Bangladesh: The importance of health–related factors and location

Abstract

BackgroundBangladesh achieved Millennium Development Goal 4, a two thirds reduction in under–five mortality from 1990 to 2015. However neonatal mortality remains high, and neonatal deaths now account for 62% of under–five deaths in Bangladesh. The objective of this paper is to understand which newborns in Bangladesh are receiving postnatal care (PNC), a set of interventions with the potential to reduce neonatal mortality.MethodsUsing data from the Bangladesh Maternal Mortality Survey (BMMS) 2010 we conducted logistic regression analysis to understand what socio–economic and health–related factors were associated with early postnatal care (PNC) by day 2 and PNC by day 7. Key variables studied were maternal complications (during pregnancy, delivery or after delivery) and contact with the health care system (receipt of any antenatal care, place of delivery and type of delivery attendant). Using data from the BMMS 2010 and an Emergency Obstetric and Neonatal Care (EmONC) 2012 needs assessment, we also presented descriptive maps of PNC coverage overlaid with neonatal mortality rates.ResultsThere were several significant findings from the regression analysis. Newborns of mothers having a skilled delivery were significantly more likely to receive PNC (Day 7: OR = 2.16, 95% confidence interval (CI) 1.81, 2.58; Day 2: OR = 2.11, 95% 95% CI 1.76). Newborns of mothers who reported a complication were also significantly more likely to receive PNC with odds ratios varying between 1.3 and 1.6 for complications at the different points along the continuum of care. Urban residence and greater wealth were also significantly associated with PNC. The maps provided visual images of wide variation in PNC coverage and indicated that districts with the highest PNC coverage, did not necessarily have the lowest neonatal mortality rates.ConclusionNewborns of mothers who had a skilled delivery or who experienced a complication were more likely to receive PNC than newborns of mothers with a home delivery or who did not report a complication. Given that the majority of women in Bangladesh have a home delivery, strategies are needed to reach their newborns with PNC. Greater focus is also needed to reach poor women in rural areas. Engaging community health workers to conduct home PNC visits may be an interim strategy as Bangladesh strives to increase skilled delivery coverage.

Correlation of Apgar score with serum glucose, calcium and electrolytes on the asphyxiated neonates

“…4 Though asphyxia is caused due to poor maternal health condition or complications during labor, newborn asphyxia would be treatable if postpartum mother and their newborns receive first-aid healthcare during or after labor. 5 It has been reported that some basic and effective resuscitation can save majority of newborns who develop asphyxia. 6 However, many newborn babies are suffered from asphyxia deprived of receiving adequate resuscitative care in the developing world and because of the limitations in skilled providers who know how to use simple resuscitation methods and equipments.…”

Optimum utilization of antenatal and postnatal cares among young women in Tigray, Northern Ethiopia: A community based-cross sectional study

“…This high dropout could be explained by different reasons like: cultural barriers [13,[50][51][52], dissatisfaction from previous service [52], and autonomy to receive health service [13]. A possible further explanation for the low use of PNC might be also due to low level of awareness about the importance of the service even when there are no complications after birth [6,10,13,28,31,46].…”

“…Literature yields that age, wealth status, ability to communicate with health care providers, and the existence of health complications [7,13,[28][29][30][31]. Cultural and social norms also inhibit young to ask, obtain information, discuss and express their worries about sexual and reproductive health issues because it is often considered as taboos to discuss sexuality issues with families or community members [30,32].…”

“…Moreover, health services utilization in most of low-income countries depends on household out of pocket payment, obviously reduced in poorer families [33]. In addition, families in different countries seem to view PNC as a service needed only when there is a problem with the mother or newborn [31,34] and being apparently healthy was the most mentioned reason for not attending PNC in Ethiopia [28]. Thus, young women need special attention in order to improve the utilization of ANC and PNC services.…”

Effectiveness of participatory community solutions strategy on improving household and provider health care behaviors and practices: A mixed-method evaluation

“…Evidence shows that use of MNH services is influenced by myriad socio-demographic, health service-related, and cultural factors [16][17][18][19][20][21][22][23][24][25][26]. Multiple studies find maternal age, parity, lack of time, education, marital status, women's economic status, residence, and distance to health facility are significant predictors of use of maternity care services [16,18,27,28]. Accordingly, intervention strategies targeting improved use of MNH services should address both supply-and demand-side factors.…”