Spatial patterns and determinants of postnatal care use in Ethiopia: findings from the 2016 demographic and health survey

Sisay, Malede Mequanent; Geremew, Tesfahun Taddege; Demlie, Yeshambel Worku; Alem, Asaye Tariku; Beyene, Desalew Kassahun; Melak, Melkitu Fentie; Gelaye, Kassahun Alemu; Ayele, Tadesse Awoke; Andargie, Asrat Atsedeweyn

doi:10.1136/bmjopen-2018-025066

Cited by 41 publications

(65 citation statements)

References 21 publications

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“…(63%) (25). Though, this finding was higher than the 2016 DHS report 6.9% in Ethiopia [ 16 ], 2013 DHS 29% in Nigeria [ 18 ], 2015/2016 DHS 48.4% in Malawi [ 17 ], and a systematic review conducted in developing countries (36%) [ 12 ]. The possible reason for the observed difference might be occurred due to the existence of health system infrastructure and socio-cultural variations across countries.…”

Section: Discussionmentioning

confidence: 78%

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Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries

et al. 2020

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Introduction Globally, over 65% of maternal deaths occur during the first 42 days of postpartum while the same proportion of neonatal deaths occur during the first 7 days of life. In sab- Saharan Africa, 4.7 million mothers, newborns, and children die on annual basis. As to our knowledge, there is no study on postnatal care utilization that incorporates all sub-Saharan Africa countries that had DHS data. Therefore, this study aimed at identifying pooled magnitude and determinants of postnatal care utilization in sub-Saharan Africa. Method A population-based cross-sectional study from the most recent Demographic and Health Surveys data from the period of 2006 to 2018 of 36 SSA countries were used. A total weighted sample of 286,255 reproductive-age women who gave birth 5 years preceding the survey were included in the study. A meta-analysis of DHS data of each Sub-Saharan countries was conducted to generate pooled magnitude and a forest plot was used to present it. A multilevel logistic regression model was fitted to identify determinants of postnatal care utilization. The AOR (Adjusted Odds Ratio) with their 95% CI and p-value ≤0.05 was used to declare that determinates associated with postnatal care utilization. Result The pooled magnitude of postnatal care utilization in sub-Saharan Africa countries was 52.48% [95% CI: 52.33, 52.63], with the highest postnatal care utilization in the Central Region of Africa (73.51%) and the low postnatal care utilization in Eastern Regions of Africa (31.71%). In the multilevel logistic regression model region, residence, age group, maternal education, maternal occupation, media exposure, ANC visit, place of delivery, and accessing health care were determinants of postnatal care utilization in Sub-Saharan Africa. Conclusion The coverage of postnatal care service utilization was low with high disparities among the region. Being in rural residence, young age group, low education level, had no occupation, not exposed to media, a big problem to access health care, not had ANC visit, and home delivery was associated with low postnatal care service utilization. This study evidenced that there is a wide gap in postnatal care utilization between SSA countries. Special attention is required to improve health accessibility, utilization, and quality of maternal health services to increase postnatal care service utilization in the region.

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Section: Discussionmentioning

confidence: 78%

“…In the previous studies, the logistic regression model was used, which cannot address a problem of nonindependence [1,3,13,16,17]. But in this study, we used the multilevel model, which can handle both individual and community-level characteristics.…”

Section: Introductionmentioning

confidence: 99%

Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries

et al. 2020

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“…Furthermore, region was another important factor that was associated with delayed PNC attendance in which women from Oromia and Gambela region had higher odds of delayed first PNC attendance. Other studies also revealed region as an important factor for the utilization of maternal health services including postnatal care [ 24 , 37 , 38 ]. The possible explanation for this might be due to the sociocultural difference between regions as well as the differences in the accessibility and quality of care.…”

Section: Discussionmentioning

confidence: 99%

Individual and community level factors associated with delayed first postnatal care attendance among reproductive age group women in Ethiopia

Teshale

Tesema

Yeshaw

et al. 2021

BMC Pregnancy Childbirth

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Background Postnatal care (PNC) visits provide a huge benefit for ensuring appropriate breastfeeding practices, to monitor the overall health status of the newborn, to timely diagnose and intervene birth-related complications, and to plan future family planning options. Despite delayed PNC attendance have a great impact on the survival of the mother and the newborn it still receives less emphasis. As a result, most mothers do not receive PNC services early. We, therefore, aimed to determine individual and community level factors associated with delayed first Postnatal Care attendance among reproductive age group women in Ethiopia. Methods We used the most recent Ethiopian Demographic and Health Survey (EDHS 2016) data to determine associated factors of delayed first PNC in Ethiopia. A weighted sample of 4308 women with a live birth in the two years preceding the survey was included. A multilevel logistic regression analysis was used to analyze the data. Variables with p-value < 0.05 in the multivariable multilevel logistic regression analysis were declared significantly associated with delayed first PNC attendance. Results In this study, both individual level and community level factors were associated with delayed PNC attendance. Among the individual level factors: having four or more antenatal care visit [Adjusted Odd Ratio (AOR) = 0.73; 95% CI: 0.59, 0.92], delivery at a health facility [AOR = 0.04; 95% CI: 0.03, 0.05], and perceiving distance from the health facility as not a big problem [AOR = 0.73; 95% CI: 0.58, 0.91] were associated with lower odds of delayed first PNC attendance. Of community level factors: being in Oromia [AOR = 2.31; 95% CI: 1.38, 3.83] and Gambela [AOR = 2.01; 95% CI: 1.13, 3.56] regions were associated higher odds of delayed first PNC attendance. Conclusions Both individual level and community level factors were found to be associated with delayed PNC attendance. Strengthening antenatal care utilization, institutional delivery, and appropriate distributions of maternal health services in each region and areas far apart from the health facility are recommended.

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“…According to Koblinsky and colleagues [ 13 ], the traditional home confinement of women after childbirth in Ethiopia contributes to the low use of PNC services. Others also reported significant regional variations in the use of ANC in Ethiopia with low levels reported in Somali, Oromia, Gambella and Southern Nations, Nationalities, and People’s Region (SNNPR) [ 14 ]. These findings imply the need for national and regional level interventions that target individual women, their families and surrounding communities as well as health care professionals and the wider health care system to improve the utilisation of maternity care services in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Postnatal Care Service Utilisation in Ethiopia: Reflecting on 20 Years of Demographic and Health Survey Data

Mekonnen

Dune

Perz

et al. 2020

IJERPH

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Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban–rural variations of PNC service utilisation. Methods: This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation. Results: Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6–6.9%) in 2000 to 18.5% (95% CI: 16.4–20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6–30.7%) in 2000 to 47% (95% CI: 60.4–67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women. Conclusions: The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopia.

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Spatial patterns and determinants of postnatal care use in Ethiopia: findings from the 2016 demographic and health survey

Cited by 41 publications

References 21 publications

Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries

Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries

Individual and community level factors associated with delayed first postnatal care attendance among reproductive age group women in Ethiopia

Postnatal Care Service Utilisation in Ethiopia: Reflecting on 20 Years of Demographic and Health Survey Data

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