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Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey.

ABSTRACT: BACKGROUND:The first 2 days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first 2 days after childbirth can help avert maternal mortality because it allows early detection of problems that could result in adverse maternal health outcomes. Unfortunately, knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed at reducing maternal mortality, remains low in Uganda. Therefore, the purpose of this study is to investigate the determinants of early postnatal care attendance among Ugandan women. METHODS:This study was based on nationally representative data from the 2016 Uganda Demographic and Health Survey. The study sample comprised 5471 women (age 15-49) who delivered a child in the 2?years preceding the survey. We used logistic regression to identify factors associated with use of early postnatal care. RESULTS:Our findings showed that 50% of mothers used EPNC services for their most recent delivery in the 2?years preceding the survey. Women's residence, education level, religion, wealth status, marital status, occupation, antenatal care attendance, place of delivery, birth order, perceived accessibility of health facilities, and access to mass media messages were associated with greater use of EPNC. The percentage of women receiving EPNC was much higher among women who delivered at a health facility, either a public facility (63%) or private facility (65%), versus only 9% among women who delivered at home. Multivariate analysis showed that delivery at a health facility was the most important determinant of early postnatal care attendance. CONCLUSIONS:To increase mothers' use of EPNC services and improve maternal survival in Uganda, programs could promote and strengthen health facility delivery and ensure that EPNC services are provided to all women before discharge. Even so, the fact that only about two-thirds of women who delivered at a health facility received early postpartum care shows substantial room for improvement. Interventions should target women who deliver at home, women who attend fewer than four antenatal care visits, and women with a primary education.

SUBMITTER: Ndugga P

PROVIDER: S-EPMC7076947 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey.

Ndugga Patricia P Namiyonga Noor Kassim NK Sebuwufu Deogratious D

BMC pregnancy and childbirth 20200316 1

<h4>Background</h4>The first 2 days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first 2 days after childbirth can help avert maternal mortality because it allows early detection of problems that could result in adverse maternal health outcomes. Unfortunately, knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed at reducing maternal mortality, remains low in Uganda. Therefore, the purpose ...[more]

PMID: 32178635

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Project description:BackgroundPapua New Guinea (PNG) recorded 22 neonatal deaths out of every 1,000 livebirths in 2019. Some of these deaths are related to complications that arise shortly after childbirth; hence, postnatal care (PNC) utilisation could serve as a surviving strategy for neonates as recommended by the World Health Organisation. National level study on determinants of PNC uptake in PNG is limited. Utilising the Bronfenbrenner's Ecological Model of Human Development, the study aimed at assessing determinants of PNC utilisation for babies by their mothers aged 15-49 in PNG.MethodsThe study used data from the women's file of the 2016-18 PNG Demographic and Health Survey (2016-18 PNGDHS) and a sample of 4,908 women aged 15-49 who had complete information on the variables of interest to the study. Nineteen (19) explanatory variables were selected for the study whereas PNC for babies within first two months after being discharged after birth was the main outcome variable. At 95% confidence interval (95% CI), six multilevel logistic models were built. The Akaike Information Criterion (AIC) was used to assess models' fit. All analyses were carried out using STATA version 14.0.ResultsGenerally, 31% of the women utilised PNC for their babies. Women with primary education [aOR = 1.42, CI = 1.13-1.78], those belonging to the middle wealth quintile [aOR = 1.42, CI = 1.08-1.87], working class [aOR = 1.28, CI = 1.10-1.49], women who had the four or more ANC visits [aOR = 1.23, CI = 1.05-1.43], those with twins [aOR = 1.83, CI = 1.01-3.29], women who belonged to community of medium literate class [aOR = 1.75, CI = 1.34-2.27] and those of moderate socioeconomic status [aOR = 1.60, CI = 1.16-2.21] had higher odds of seeking PNC for their babies. The odds to seek PNC services for babies reduced among the cohabiting women [aOR = 0.79, CI = 0.64-0.96], those at parity four or more [aOR = 0.77, CI = 0.63-0.93], women who gave birth to small babies [aOR = 0.80, CI = 0.67-0.98] and residents in the Highlands region [aOR = 0.47, CI = 0.36-0.62].ConclusionsMaternal education, wealth quintile, occupation, partner's education, ANC visits, marital status, parity, child size at birth, twin status, community literacy and socioeconomic status as well as region of residence were associated with PNC uptake for babies in PNG. Variation in PNC uptake for babies existed from one community/cluster to the other. There is the need to strengthen public health education to increase awareness about the benefits of seeking PNC services for babies among women in PNG. Such programs should consider maternal and community/cluster characteristics in their design.

Project description:IntroductionReturning to health facility for postnatal care (PNC) use after giving birth at health facility could reflect the health seeking behavior of mothers. However, such studies are rare though they are critically important to develop vigorous strategies to improve PNC service utilization. Therefore, this study aimed to determine the magnitude and factors associated with returning to health facilities for PNC among mothers who delivered in Ethiopian health facilities after they were discharged.MethodsThis cross-sectional study used 2016 Ethiopian Demographic and Health Survey data. A total of 2405mothers who gave birth in a health facility were included in this study. Multilevel mixed-effect logistic regression model was fitted to estimate both independent (fixed) effects of the explanatory variables and community-level (random) effects on return for PNC utilization. Variable with p-value of ≤ 0.25 from unadjusted multilevel logistic regression were selected to develop three models and p-value of ≤0.05 was used to declare significance of the explanatory variables on the outcome variable in the final (adjusted) model. Analysis was done using IBM SPSS statistics version 21.ResultIn this analysis, from the total 2405 participants, 14.3% ((95%CI: 12.1-16.8), (n = 344)) of them returned to health facilities for PNC use after they gave birth at a health facility. From the multilevel logistic regression analysis, being employed (AOR = 1.51, 95%CI: 1.04-2.19), receiving eight and above antenatal care visits (AOR = 2.90, 95%CI: 1.05-8.00), caesarean section delivery (AOR = 2.53, 95%CI: 1.40-4.58) and rural residence (AOR = 0.56, 95%CI: 0.36-0.88) were found significantly associated with return to health facilities for PNC use among women who gave birth at health facility.ConclusionFacility-based PNC utilization among mothers who delivered at health facilities is low in Ethiopia. Both individual and community level variables were determined women to return to health facilities for PNC use. Thus, adopting context-specific strategies/policies could improve PNC utilization and should be paid a due focus.

Dataset Information

Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey.

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Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey.

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