Prevalence of adequate postnatal care and associated factors in Rwanda: evidence from the Rwanda demographic health survey 2020

Abstract

Background Although quality postnatal care (PNC) is a known significant intervention for curbing maternal and newborn morbidity and mortality, it is underutilized in most developing countries including Rwanda. Thus, it is crucial to identify factors that facilitate or occlude receipt of adequate PNC. This study aimed at assessing the prevalence of adequate PNC content and the associated factors in Rwanda. Methods We used weighted data from the Rwanda Demographic and Health Survey (RDHS) of 2020, comprising of 4456 women aged 15–49 years, who were selected using multistage sampling. Adequate PNC was considered if a woman had received all of the five components; having the cord examined, temperature of the baby measured, counselling on newborn danger signs, counselling on breastfeeding and having an observed breastfeeding session. We, then, conducted multivariable logistic regression to explore the associated factors, using SPSS version 25. Results Out of the 4456 women, 1974 (44.3, 95% confidence interval (CI): 43.0–45.9) had received all the PNC components. Having no radio exposure (adjusted odds ratio (AOR) =1.41, 95% CI: 1.18–1.68), visited by a fieldworker (AOR = 1.35, 95% CI: 1.16–1.57), no big problem with distance to a health facility (AOR = 1.50, 95% CI:1.24–1.81), and residing in the Southern region (AOR = 1.75, 95% CI: 1.42–2.15) were associated with higher odds of adequate PNC compared to their respective counterparts. However, having no exposure to newspapers/magazines (AOR = 0.74, 95% CI: 0.61–0.89), parity of less than 2 (AOR = 0.67, 95% CI: 0.51–0.86), being a working mother (AOR = 0.73, 95% CI: 0.62–0.85), no big problem with permission to seek healthcare (AOR = 0.54, 95% CI: 0.36–0.82), antenatal care (ANC) frequency of less than 4 times (AOR = 0.79, 95% CI: 0.62–0.85), inadequate ANC quality (AOR = 0.56, 95% CI: 0.46–0.68), and getting ANC in a public facility (AOR = 0.57, 95% CI: 0.38–0.85) were associated with lower odds of adequate PNC. Conclusions Less than half of the mothers in Rwanda had received adequate PNC, and this was associated with various factors. The results, thus, suggested context-specific evidence for consideration when rethinking policies to improve adequate PNC, including a need for intensified PNC education and counselling during ANC visits, continued medical education and training of PNC providers, and strengthening of maternal leave policies for working mothers. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00964-6.

Human Immunodeficiency Virus testing and associated factors among pregnant women in Rwanda: a nationwide cross-sectional survey

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Multilevel mixed effect analysis of adequate postnatal care in Ethiopia: Evidence from EMDHS, 2019

“…Based on WHO recommendations [21] and the availability of data in the 2019 EMDHS dataset, adequate PNC content was de ned as a woman receiving all ve PNC components, which included having the cord examined, measuring the baby's temperature, counseling on newborn danger signs, counseling on breastfeeding, and having an observed breastfeeding session. Women who had taken fewer than ve of the components were considered to have received inadequate postnatal care ("labeled as 0"), while those who had taken ve of the ve components of PNC were taken as having received adequate PNC ("labeled as 1") [15]. The women provided this information on their own.…”

“…A cross sectional study conducted from review of 2016 Rewanda demographic and health survey in showed that only 44.3% newborns got all of the ve recommended postnatal care services [15]. A cross sectional study conducted in a northern Ethiopia showed that the prevalence of utilization of at least one PNC was only 24.6% [16].…”