Predictors of Postnatal Care Supplements in Bole Sub-City Health Centers Under the COVID-19 Environment: Analysis of Service User’s Perspective

Abstract

<i>Background:</i> Postnatal Care (PNC) visits help decrease maternal morbidity and mortality right after delivery. However, the services are severely affected during crisis time, such as the recent COVID-19 pandemic, as most health care services were suspended and shifted to combat the pandemic. <i>Objective</i>: 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, Addis Ababa, under the COVID-19 pandemic. <i>Method</i>: A sample size of 405 mothers with the most recent births who got the service in selected health centers in Bole Sub-City were interviewed. A Negative Binomial (NB) regression analysis was used to assess the determinants of postnatal supplement intake. <i>Results</i>: 44.9 percent of the respondents used Post Natal Care (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 times (95%CI: 1.121-1.346) compared to women aged 35 and above. The mean number of postpartum intakes decreased by 38.1 percent (IRR=0.619; 95%CI: 0.548-0.700) for women who were currently living with their husbands compared to the reference category. For women who had 2-3 children, postpartum supplement intake decreased by 32.8 percent (IRR=0.672; 95%CI: 0.618-0.730). Women with primary education had lower intake (IRR=0.903, 95%CI: 0.825-0.987) than those who had college or university education. 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) among those with very low and low household income, respectively. Intake was higher among Orthodox Christian and Muslim women by 1.092 times (95%CI: 1.010-1.180) and 1.24 times (95%CI: 1.136-1.354), respectively when compared to followers of other religion (i.e., Catholics and Protestants). Women who were not engaged in gainful employment had significantly higher mean score of intakes (IRR=1.130; 95%CI: 1.063-1.202) compared to those working during the survey period. <i>Conclusion: </i>Given the higher likelihood of maternal morbidity and mortality during the postpartum period, the findings suggest that continued awareness creation and health education to mothers could make a significant increase in the access and uptake of both supplement intake and PNC services.