Uptake of complete postnatal care services and its determinants among rural women in Southern Ethiopia: Community-based cross-sectional study based on the current WHO recommendation

Abstract

Background Postnatal care services are a constellation of preventive care, practices, and assessments designed to identify and manage maternal and newborn complications during the first six weeks after birth. Recognizing the role of the appropriate PNC at this critical time, the World Health Organization recommended four visits as a complete PNC for all post-partum mothers and newborns to ensure their survival. Although there have been numerous studies on the factors affecting the general PNC service in Ethiopia, there is a shortage of evidence on the use of complete postnatal care services and its determinants. Therefore, the objective of this study was to assess the uptake of full postnatal care service and its determinants among women who recently gave birth in the Ezha district of southern Ethiopia. Methods A community-based cross-sectional study was conducted in Ezha district. A two-stage sampling technique was applied. A total of 568 mothers who stayed for at least 6 weeks after childbirth from selected Kebeles were included in the study using computer-generated random numbers. Data collected through pre-established, structured, and interviewer-administered questionnaires were entered into EpiData3.1 and exported to SPPS version 23 for analysis. The Principal Components Analysis (PCA) was carried out to assess the wealth status of participants. The Multivariable logistic regression model has been fitted to identify the determinants of complete post-natal care service uptake. Results The overall uptake of complete postnatal care services in the study area was 23.9% [95% CI: (19.9, 27.5)]. The factors namely; maternal education of secondary and above [AOR: 4.31, 95%CI: 2.15, 8.05], having four and more antenatal visits [AOR: 4.03, 95%CI: 1.83, 8.85], Caesarean delivery [AOR: 3.75, 95%CI: 1.78, 7.92], having good knowledge on PNC [AOR: 4.31, 95%CI: 2.34, 9.04], and being a model household [AOR: 3.61, 95%CI: 1.97, 6.64] were recognized as determinants complete postnatal care uptake. Conclusion and recommendation Complete post-natal care services uptake in the study area was low. Thus, a due emphasis should be given to behavioral change communication activities to improve maternal knowledge on PNC and enhancing adequate ANC uptake by health workers in the district. Besides, health extension workers in the district need to work on creating a model household through continuing education, support, and follow-up.

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

“…We found that 85.6% of both the women and their neonates had at least one PNC contact, and this was associated with both individual and health system/policy factors. Although, slightly lower than the 90% level of PNC coverage recommended by WHO [ 28 ], it is higher than the reported prevalence of 48.4% for Malawi, 63% for Zambia and 78.4% for Indonesia [ 29 – 31 ]. This level of utilisation is commendable and should be further supported by government interventions, aimed at providing free maternal and child health services through the FHCI project.…”

“…Similarly, in this study the odds of PNC utilisation were higher among woman who had eight or more ANC contacts compared to their counterparts who had fewer. This may be attributed to the fact that regular contact with health workers during ANC, accords more opportunities for education and counselling about the need to seek for health care services during and after pregnancy [ 28 , 31 , 38 ]. Mothers who had at least one visit by a health field worker had higher odds of PNC utilisation, a finding similar to that of other studies done in similar contexts [ 39 , 40 ].…”

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

“…On the other hand, it is lower than the reported prevalence of 48.4% for Malawi, 63% for Zambia and 78.4 % for Indonesia [26][27][28]. This observed PNC utilisation is lower than the 90% recommended PNC coverage by WHO [29], which continues to limit the early identi cation of postpartum complications among the women and the newborns in the country. This situation is particularly worrying because about 40% of the reported maternal and perinatal morbidity and mortality occur in the immediate postpartum period.…”

“…Similarly, in this study the odds of PNC utilisation were two times higher among woman who had eight or more ANC contacts compared to their counterparts who had fewer. This may be attributed to the fact that regular contact with health workers during ANC, accords more opportunities for education and counselling about the need to seek for health care services during and after pregnancy [28, 29,34]. However, there is need to explore the mechanisms associated with increased odds of PNC utilisation among women who initiate ANC after the rst trimester.…”

“…The mean age and household size were 28.97 ± 7.25 and 6.93 ± 3.45 respectively. [29], which continues to limit the early identi cation of postpartum complications among the women and the newborns in the country. This situation is particularly worrying because about 40% of the reported maternal and perinatal morbidity and mortality occur in the immediate postpartum period.…”