The role of community-based health services in influencing postnatal care visits in the Builsa and the West Mamprusi districts in rural Ghana

Evelyn Sakeah,Daniel Azongo,Raymond Aborigo,Abraham Rexford Oduro,Ernest Kanyomse,Dominic Anaseba,Samuel Oladokun,James Kotuah Sakeah,Maxwell Dalaba

doi:10.1186/s12884-018-1926-7

Abstract

BackgroundGlobally, maternal mortality is still a challenge. In Ghana, maternal morbidity and mortality rates remain high, particularly in rural areas. Postnatal Care (PNC) is one of the key strategies for improving maternal health. This study examined determinants of at least three PNC visits in rural Ghana.MethodsWe conducted a cross-sectional study at the Community-Based Health Planning and Services (CHPS) Zones in the Builsa and West Mamprusi Districts between April and June 2016. We selected 650 women who delivered within 5 years preceding the survey (325 from each of the two sites) using the two-stage random sampling technique.ResultsOf the 650 respondents, 62% reported attending postnatal care at least three times. In the Builsa district, the percentage of women who made at least three PNC visits were 90% compared with 35% in the West Mamprusi district. Older women and those who attended antenatal clinics at least four times (AOR: 5.23; 95% CI: 2.49–11.0) and women who had partners with some secondary education (AOR: 3.31; 95% CI: 1.17–9.39) were associated with at least three PNC visits.ConclusionsMen engagement in maternal health services and the introduction of home-based PNC services in rural communities could help health workers reach out to many mothers and children promptly and improve PNC visits in those communities.

Highlights

This study evaluates the effectiveness of the intervention program comparing Postnatal Care (PNC) service access in Community-Based Health Planning and Services (CHPS) zones in two rural communities, one with home-based postnatal care (Builsa) and one without this service (West Mamprusi)
The findings suggest that, previous reproductive health activities such as Antenatal Care (ANC), skilled delivery, PNC and family planning services offered an important avenue for older women to establish contact with health services and develop a good relationship with health care providers which leads to an increase in utilization
The availability and access to PNC services in rural communities, at the home-based level and male involvement in maternal health care could improve the use of PNC services in rural settings

Summary

Introduction

In Ghana, maternal morbidity and mortality rates remain high, in rural areas. Despite the establishment of a number of global and national initiatives to improve maternal health, maternal mortality is still a major concern in sub-Saharan Africa [1]. Every year in Africa, at least 125,000 women and 870,000 newborns die in the first week after birth [2]. In 2015, global maternal mortality was 303,000 with sub-Saharan Africa accounting for the highest number of deaths (201,000) [1]. Postnatal care (PNC) is the care given to the mother and her newborn baby immediately after the birth and for the first 6 weeks of life [2]. The first 6 weeks after birth is known as the PNC period [2].

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Conclusion