The role of community-based health services in influencing postnatal care visits in the Builsa and the West Mamprusi districts in rural Ghana

Abstract

BackgroundGlobally, maternal mortality is still a challenge. In Ghana, maternal morbidity and mortality rates remain high, particularly in rural areas. Postnatal Care (PNC) is one of the key strategies for improving maternal health. This study examined determinants of at least three PNC visits in rural Ghana.MethodsWe conducted a cross-sectional study at the Community-Based Health Planning and Services (CHPS) Zones in the Builsa and West Mamprusi Districts between April and June 2016. We selected 650 women who delivered within 5 years preceding the survey (325 from each of the two sites) using the two-stage random sampling technique.ResultsOf the 650 respondents, 62% reported attending postnatal care at least three times. In the Builsa district, the percentage of women who made at least three PNC visits were 90% compared with 35% in the West Mamprusi district. Older women and those who attended antenatal clinics at least four times (AOR: 5.23; 95% CI: 2.49–11.0) and women who had partners with some secondary education (AOR: 3.31; 95% CI: 1.17–9.39) were associated with at least three PNC visits.ConclusionsMen engagement in maternal health services and the introduction of home-based PNC services in rural communities could help health workers reach out to many mothers and children promptly and improve PNC visits in those communities.

Effect of enhanced reminders on postnatal clinic attendance in Addis Ababa, Ethiopia: a cluster randomized controlled trial

“…We also found that, compliance with ANC clinic attendance in the index pregnancy (having 4 or more ANC visits) were found to increase the compliance with the PNC visits. Similar studies from Ethiopia, Ghana and Indonesia supported this finding [9,[55][56][57]. The positive health-seeking behavior among those with higher ANC attendance might be the reason.…”

Complete postnatal care utilizations and its associated factors among women who gave birth in the last 12 months in Ezha district, Southern Ethiopia, 2019 ( Community-based cross-sectional study , compliance with WHO recommendation)

“…The study found that frequency of ANC visit had signi cant association with utilization of the complete post natal care. This nding was in tandem with prior studies done in Ghana in 2016, where mother with four and more antenatal visits were 5.23 times more likely to receive CPNC [19]. It has been known that antenatal care exposes pregnant women to counseling and education about their own health and care of their children and may be particularly advantageous for those mothers and newborns in limiting settings, where health seeking behaviors are inadequate and access to health services is limited [2,4].In addition, women who make at least four ANC attendances are more likely to be those who adhere to health recommendations and therefore with higher chance of complying with the required number of PNC visits [19].…”

“…This nding was in tandem with prior studies done in Ghana in 2016, where mother with four and more antenatal visits were 5.23 times more likely to receive CPNC [19]. It has been known that antenatal care exposes pregnant women to counseling and education about their own health and care of their children and may be particularly advantageous for those mothers and newborns in limiting settings, where health seeking behaviors are inadequate and access to health services is limited [2,4].In addition, women who make at least four ANC attendances are more likely to be those who adhere to health recommendations and therefore with higher chance of complying with the required number of PNC visits [19]. The potential reason behind this could be, as a mother had more frequent contact with health care providers, she might have more chance to be counseled on the importance of PNC, its availability, recommended timing and targeted frequency of postnatal visits, and could result in CPNC utilization.…”

“…The nding was lower as compared to the reports from studies conducted in Myanmar, in 2016 and Northern Ethiopia, in 2017 where 25.2% & 28.4% of the mothers had attended complete postnatal care within the rst six weeks of delivery respectively [17,21]. Furthermore, huge variation was noticed in two additional studies done in India in 2013 and rural Ghana (Builsa and Mamprusi districts) in 2016 where 61% & 62% of mothers got at least three recommended PNC visits respectively [18,19].This disparity might be explained by the socio-demographic variation between the study participants such as educational level and living standard as well as nature of the study area including better access to healthcare and information and health education.…”

“…Only 13% of the mothers in the sub-Saharan Africa were received postnatal care checkup appropriately in line with WHO recommendation [14,16].Although improvement has been made in increasing the accessibility for most of maternal and child health services, reports showed that national prevalence of PNC service utilization in Ethiopia is still low with 17% coverage [16]. Studies conducted in few countries namely Myanmar, India, rural Ghana, Tanzania and Ethiopia showed that the magnitude of complete PNC utilization lies within the range of 10-60% [17][18][19][20][21].…”