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

Abstract

Background Accessibility and utilization of postnatal newborn check-ups within 2 days after delivery are critical for a child’s survival, growth, and development. However, the service delivery is not yet improved and fluctuates across the geographical locations in Ethiopia. Therefore, this study aimed to assess the spatial distribution and determinants of newborns not received postnatal check-ups within 2 days after birth in Ethiopia. Methods A secondary data analysis of the Ethiopia Demographic and Health Survey (EDHS) 2016 was done among live births within 2 years preceding the survey. A multilevel binary logistic regression model was fitted to identify the factors associated with the outcome variable. Adjusted Odds Ratio with 95% (Confidence Interval) was calculated and used as a measure of associations and variables with a p-value < 0.05, were declared as statistically significant. Results A total of 4036 live newborns in Ethiopia were included in the analysis, of whom half (51.21%) were females. The mean age of the mothers was 33+ SD 1.3, and more than 60 % (61.56%) of the mothers were not educated. The national prevalence of newborns not receiving postnatal check-ups within 2 days after birth was 84.29 (95% CI: 83.10–85.41) with significant spatial variations across the study area. Mothers who had no ANC visits were 58% higher than (AOR = 0.42(0.27–0.66) mothers who had > 4 ANC visits. Mothers who gave birth at home and others were 80% (AOR = 0.02(0.01–0.29) and 25% (AOR = 0.76(0.59–0.99), higher than mothers delivered at hospital. Rural mothers were 1.90 times higher (AOR = 1.90(1.29–2.81) than urban mothers, and mothers live in administrative regions of Afar 66% (AOR = 0.34(0.16–0.69), Oromia 47% (AOR = 0.53(0.30–0.91), Somali 60% (AOR = 0.40 (0.22–0.74),Benishangul 50% (AOR = 0.50 (0.27–0.92), SNNPR 67% (AOR = 0.33(0.19–0.57), Gambela 70% (AOR = 0.30 (0.16–0.56), Harari 56% (AOR = 0.44 (0.25–0.78), and Dire Dawa70% (AOR = 0.30 (0.17–0.54) were higher than Addis Abeba for not receiving postnatal checkup of new born within the first 2 days, respectively. Conclusions Low postnatal check-up utilization remains a big challenge in Ethiopia, with significant spatial variations across regional and local levels. Spatial clustering of not receiving postanal check-ups within 2 days was observed in Afar, Oromia, Gambela, Benishangul, SNNPR, Harari, and Dire Dawa regions. Residence, ANC visits, place of delivery, and administrative regions were significantly associated with not receiving postnatal check-ups. Geographically targeted interventions to improve ANC follow-up and institutional delivery should be strengthened.

Spatial patterns and determinants of low utilization of delivery care service and postnatal check-up within 2 months following birth in Ethiopia: Bivariate analysis

“…The study found that 72.55% of women give birth at home, which is consistent with previous studies from Southeast Ethiopia (73.6%) [ 31 ], EDHS 2016 report (73.3%) [ 32 ], and Gozamin District in Amhara region (75.3%) [ 33 ], but higher than studies from Afar, Ethiopia (65%), South Ethiopia (62.2%), and Arba Minch town Ethiopia (33.2%) [ 34 – 36 ], Zala woreda, Southern Ethiopia (67.6%) [ 13 ], Anlemo District, Hadiya Zone (49.3%) [ 1 ], and Wolaita and Dawro Zone (62%) [ 1 , 14 , 37 , 38 ]; in contrast it is lower than a study conducted in Arbaminch Zuria District (79.4%) [ 39 ], zone 3 of Afar region (83.3%) [ 40 ]. In terms of PNC following deliveries, around 91.45% of women did not have a PNC after giving birth; this finding is consistent with studies conducted in Ethiopia [ 41 ], but slightly higher and lower than studies conducted in the same country [ 42 , 43 ] respectively. This variation could be attributable to the study area, setting difference, cultural attitude towards health facility delivery, infrastructure difference (access to the health facility, roads, and distance to the health facility).…”

“…Postnatal care research in developing countries is scarce in comparison to antenatal care and skilled attendance at birth [ 12 ]. Few recent findings indicated that numerous characteristics, including Marital status, knowledge of the mothers on PNC service, place of residence, media exposure, place of delivery, residency, ANC follow-up, and administrative region, have been considered as determinants of postnatal care service utilization [ 17 , 18 ]. However, several studies have mainly neglected the potential impacts of geographical factors [ 19 , 20 ], and parallel effects (bivariate effects) of the place of delivery on the evaluation of PNC [ 21 ].…”

Determinants and geographic distribution of early newborn care in Ethiopia: evidence from the 2019 Ethiopian Mini Demographic Health Survey

“…Moreover, children delivered at health institutions have higher odds of early newborn care than home-delivered mothers. This is supported by a study in Uganda 31 , and Ethiopia 14 . Moreover, in this study mothers who delivered through cesarean section were more likely to have immediate newborn postnatal care than other delivery modes.…”

“…This is also in line with another study in Ethiopia 44 . This could be because mothers who gave birth at home are culturally restricted from moving out of their homes for a certain period, which reduces postnatal care utilisation 14 . Therefore, if the care is not given home to home, they might miss their visit 35 .…”

“…However, postnatal care programs are among the weakest of all reproductive health programs in low and middle-income countries such as Ethiopia 2 , 13 . There is minimal evidence on the magnitude and determinants of newborn postnatal care uptake within 2 days after birth in Ethiopia 14 . Moreover, updated evidence on the uptake of essential components of newborn postnatal care and its distribution is needed.…”