Postnatal care service utilization and its determinants in East Gojjam Zone, Northwest Ethiopia: A mixed-method study

Abstract

Background The days and weeks after childbirth are crucial for both the mother and her newborn child leading for the majority of maternal and perinatal mortalities. The World Health Organization recommends at least three postnatal visits within 42 days after birth. However, postnatal care utilization remains low worldwide. Quantitative findings revealed low utilization of postnatal care in Ethiopia, however, no study explored the barriers for postnatal care. This study aimed to assess the barriers to postnatal care service utilization in East Gojjam Zone, Northwest Ethiopia. Methods A community-based, mixed type cross-sectional study was conducted from December 15, 2018, to February 15, 2019. The quantitative data was gathered using the interviewer-administered interviewing technique from 751 women who gave birth within one year prior to the study selected by multistage sampling. The qualitative data were collected from purposively sampled women, facility leaders, and health extension workers using in-depth interviews and focused group discussions. The quantitative and qualitative data were analyzed using logistic regression and by the thematic content analysis method, respectively. Results The study revealed that postnatal care service utilization was 34.6%. The odds of using PNC services were greater in women aged 25–34 years and used maternity waiting home. In contrast, women who were muslim religion followers, had normal or instrumental birth, not aware of the PNC services and whose partners were not supportive of the use of MCH services were less likely to use PNC services. According to the qualitative findings, lack of awareness, traditional beliefs and religious practices, distance and transportation, environmental exposure, and waiting time were identified as barriers to PNC service utilization. Conclusion and recommendation The study showed low utilization of PNC services in East Gojjam zone, northwest Ethiopia. Improvements in personal health education, in construction of relevant infrastructure, and to transport, are needed to remove or reduce barriers to PNC service use in East Gojjam Zone, Northwest Ethiopia.

Postnatal Care Utilization Coverage and its Associated Factors Among Mothers in South Gondar Zone, Northwest Ethiopia: A Cross-Sectional Study

“…When compared to when it took less than 2 h to get to the nearest health institution, people who took more than 2 h were less likely to use PNC services. This finding is consistent with a study done in East Gojjam Zone, Northwest Ethiopia (34.6%) ( Zeleke et al, 2021 ) and Uganda ( Ndugga et al, 2020 ). Because of the physical difficulties of travel and the high costs of motorized transportation, postpartum women's willingness and ability to seek PNC is limited ( Izudi et al, 2017 ).…”

“…Prior to the actual data collection, the emphasis was placed on selecting the right sample size, which mostly depended on the study's objective, the available resources, and the precision required. The sample size was determined using a single population proportion formula with the assumption; 95% confidence interval, 4.7% margin of error, 10% estimated non-response rate, and taking 34.6% proportion of PNC utilization in East Gojjam Zone, Northwest Ethiopia ( Zeleke et al, 2021 ) then, the required sample size was 434. The study's individuals were assessed using a multi-stage sampling method.…”

“…The potential variables associated with PNC service utilization have been selected based on different works of literature ( Akibu et al, 2018 ; Bwalya et al, 2017 ; Debie & Tesema, 2021 ; Mosiur Rahman et al, 2011 ; Seid & Ahmed, 2020 ; Zeleke et al, 2021 ). Age of women, religion, education level of women, occupation of women, education level of husband's, husband's occupation, family size, monthly income, own mobile telephone, the decision of maternal care service utilization, access to mass media, residence, and marital status were considered to be explanatory variables within the study.…”

Uptake of postnatal care and its determinants in Ethiopia: a positive deviance approach

“…This is highly likely due to differences in religious practices and beliefs. For instance, Muslim women are restricted from leaving their houses for 45 days after birth, whereas Christian women are permitted to leave their homes 10–15 days following childbirth [ 44 ]. In that regard, the government should aval the PNC services at household level within 7 days for these who give their birth at home that can solve the religious practices and beliefs and also transportation difficulties in accessing health care.…”

Lifetime adverse pregnancy outcomes and associated factors among antenatal care booked women in Central Gondar zone and Gondar city administration, Northwest Ethiopia

“…The odds of an adverse pregnancy outcome among women who had no road access to the health facilities was 2.62 times higher than those who had road access to the health facilities. This could be because inaccessibility of roads restricts utilization of basic maternal health services like ANC, health facility delivery, and postnatal care, which leads to an increased adverse pregnancy outcome ( 44 – 46 ). Poor accessibility of road and transport facilities also affects hospital supplies, often resulting in a stock-out of essential medicines.…”