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


ABSTRACT:

Objective

Postnatal care (PNC) is essential for preventing maternal and newborn deaths; however, it still remains less well recognised in low-income and middle-income countries. This study was aimed to explore geographical patterns and identify the determinants of PNC usage among women aged 15-49 years in Ethiopia.

Methods

A secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey data. A total of 7193 women were included in this analysis. We employed spatial scan statistics to detect spatial inequalities of PNC usage among women. A multilevel binary logistic regression model was fitted to identify factors associated with women's PNC.

Results

The prevalence of PNC usage among women was 6.9% (95%?CI 6.3% to 7.5%). The SaTScan spatial analysis identified three most likely clusters with low rates of PNC use namely southwestern Ethiopia (log likelihood ratio (LLR)=18.07, p<0.0001), southeast Ethiopia (LLR=14.29, p<0.001) and eastern Ethiopia (LLR=10.18, p=0.024). Women with no education (Adjusted Odd Ratio (AOR)=0.55, 95%?CI 0.37 to 0.84) and in the poorest wealth quantile (AOR=0.55, 95%?CI 0.39 to 0.78) were less likely to use PNC, while women aged 35-49 years (AOR: 1.75, 95%?CI 1.01 to 3.04) and with at least four antenatal care (ANC) visits (AOR=2.37, 95%?CI 1.71 to 3.29) were more likely to use PNC.

Conclusion

PNC usage remains a public health problem and has spatial variations at regional levels in the country. Low prevalence of PNC was detected in the Somali, Oromia, Gambella and Southern Nations, Nationalities, and People's Region (SNNPR) regions. Women with low educational status, old age, being in poorest wealth quantile and history of ANC visits were significantly associated with PNC usage. Hence, it is better to strengthen maternal health programmes that give special emphasis on health promotion with a continuum of care during pregnancy.

SUBMITTER: Sisay MM 

PROVIDER: S-EPMC6577400 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

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

Sisay Malede Mequanent MM   Geremew Tesfahun Taddege TT   Demlie Yeshambel Worku YW   Alem Asaye Tariku AT   Beyene Desalew Kassahun DK   Melak Melkitu Fentie MF   Gelaye Kassahun Alemu KA   Ayele Tadesse Awoke TA   Andargie Asrat Atsedeweyn AA  

BMJ open 20190611 6


<h4>Objective</h4>Postnatal care (PNC) is essential for preventing maternal and newborn deaths; however, it still remains less well recognised in low-income and middle-income countries. This study was aimed to explore geographical patterns and identify the determinants of PNC usage among women aged 15-49 years in Ethiopia.<h4>Methods</h4>A secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey data. A total of 7193 women were included in this analysis. We em  ...[more]

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