Determinants of postnatal care supplements in Bole Sub-City health centers under the COVID-19 environment: Analysis of service user’s perspective

Abstract

Background: PNC visits helps decrease maternal morbidity and mortality after delivery. The services (both provision and utilization) are severely affected during crisis, such as the recent COVID-19 pandemic due to health care services being suspended and shifting to combat the pandemic. Objective: To assess the determinants and challenges of postnatal care service utilization, specifically intake of key supplements (iron, folic acid, and antibiotics) among pregnant women attending Bole Sub City Health Centers under the COVID-19 pandemic. Method: A sample size of 405 mothers with most recent births who got the service in the selected Bole Sub-City health centers were interviewed. A negative binomial regression analysis was used to assess the determinants of postnatal supplement intake. Result: 44.9 percent of the respondents used PNC services but only 10.6 percent of them took the postnatal supplements. For respondents in the age group 25-34, the expected mean number of postpartum intakes increased by 1.22 (95% CI: 1.121-1.346) compared to women 35 and above. The expected mean number of postpartum intake decreased by 38.1 percent (IRR = 0.619; 95% CI: 0.548-0.700) for women who were currently living with their husbands when compared to those who don’t. For women who had 2-3 children, the expected mean number of postpartum supplement intake decreased by 32.8 percent (IRR = 0.672; 95% CI: 0.618 - 0.730) compared to the reference category. Women with primary education, had an expected mean number to decrease by 10 percent (IRR = 0.903, 95% CI: 0.825- 0.987) than those who had college or university education. Those with very low and low household income, the expected mean number of postnatal supplement intake decreased by 25.7 percent (IRR = 0.743, 95% CI: 0.678-0.814) and 22.9 percent (IRR = 0.771, 95% CI: 0.706- 0.841) respectively. But increased by 1.257 (95% CI: 1.227-1.403) for women in the moderate household wealth. Orthodox Christian and Muslim women had the expected mean number to increase by 1.092 (95% CI: 1.010-1.180) and 1.24 (95% CI: 1.136-1.354) respectively when compared to the reference category. Working women had an expected mean number of postnatal supplement intake of 1.13 (95% CI: 1.063-1.202) when compared with those who don’t have work. Lastly for women who had PNC visits, the expected mean number of postnatal supplement intake increased by 1.138. Conclusion: Maternal morbidity and mortality is the highest during post-partum period. But this could be minimized by attending postnatal care services. This study suggests increasing awareness in mothers to attend the recommended number of visit to secure health of the mothers and their newborn. Keywords: postnatal service; iron; folate; supplement; health center.