Abstract
BackgroundWithin Sub-Saharan Africa, some countries still report unacceptably high rates of maternal and perinatal morbidity and mortality, despite improvements in the utilisation of maternity care services. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone.MethodsWe used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25.ResultsOut of 7326 women, 6625 (90.4, 95% CI: 89.9–91.2) had at least one PNC contact for their newborn, 6646 (90.7, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 6274 (85.6, 95% CI: 85.0–86.6) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 8.01, 95% CI: 3.37–19.07), having a visit by a health field worker (aOR 1.80, 95% CI: 1.46–2.20), having had eight or more ANC contacts (aOR 1.37, 95% CI: 1.08–1.73), having tertiary education (aOR 2.71, 95% CI: 1.32–5.56) and having no big problems seeking permission to access healthcare (aOR 1.51, 95% CI: 1.19–1.90) were associated with higher odds of PNC utilisation. On the other hand, being resident in the Northern (aOR 0.48, 95% CI: 0.29–0.78) and Northwestern regions (aOR 0.54, 95% CI: 0.36–0.80), belonging to a female headed household (aOR 0.69, 95% CI: 0.56–0.85) and being a working woman (aOR 0.66, 95% CI: 0.52–0.84) were associated with lower odds of utilizing PNC.ConclusionFactors associated with utilisation of PNC services operate at individual, household, community and health system/policy levels. Some of them can be ameliorated by targeted government interventions to improve utilisation of PNC services.
Highlights
Sub-Saharan Africa records the highest maternal deaths at 500 per 100,000 live births, and newborn deaths at 34 per 1000 live births [1], which accounts for 38% of the global neonatal deaths
Mass media exposure was limited with 57.7% of women not exposed to radio, 76.2% not exposed to TV, 89.9% not using internet and 94.5% not exposed to newspapers
Regarding content of Postnatal care (PNC), 4895 women (66.8, 95% confidence interval (CI): 65.7–67.8) had all the contents of PNC check that included: examining the code, temperature being taken, breastfeeding and newborn danger signs counseling and having a practical breastfeeding session with the health provider as shown in Supplementary file 2
Summary
Sub-Saharan Africa records the highest maternal deaths at 500 per 100,000 live births, and newborn deaths at 34 per 1000 live births [1], which accounts for 38% of the global neonatal deaths. The immediate postpartum period is critical for the survival of both mothers and newborns because that is when most physiological adaptations occur [1, 5] In this regard, receipt of timely postnatal care (PNC) is widely used to track progress towards national and international maternal child health goals [9, 10]. PNC is one of the recommended packages in the continuum of maternity care, aimed at reducing maternal and neonatal mortality [1, 11] This service consist of care given to mothers and neonates right after delivery and up to 6 weeks of postpartum with the aim of ensuring optimum health for the mother and the infant [1]. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone
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