Postnatal Care Services Research Articles

Attitude of postpartum women towards multiple postnatal clinic schedule in south-west Nigeria.

The postnatal period is a critical in the lives of mothers and babies due to the risk of maternal and perinatal morbidity and mortality. According to the Nigeria Demographic Health Survey 2018, only 38% of women and 42;% of newborns received a postnatal check in the first 2 days after birth. The World Health Organisation (WHO) recommends that postpartum women should have contact with healthcare providers within 24h, at day 3, days 10-14 and 6 weeks post-delivery. Multiple postnatal clinic (PNC) visits will allow assessment and prompt treatment of complications arising from delivery. This study assessed the attitude of postpartum women towards multiple PNC schedule. This descriptive cross-sectional study assessed the attitude of postpartum women towards multiple PNC schedules. A total of 167 respondents participated in the study and data was collected using a semi-structured interviewer administered questionnaire. Information on awareness, knowledge and purpose of postnatal care, preference for multiple schedules and the timing of postnatal care visits were obtained. Data was analysed using IBM SPSS version 23; and the level of significance was set at p<0.05. Of the respondents, 71.9% had poor or incorrect knowledge. About 87.4% perceived PNC as beneficial; and that mothers and newborns should be seen at least three times (47.9%) in the postnatal period. A high proportion of women were willing to come for PNC on day 3 (74.3%), days 10-14 (86.2%) and six weeks postpartum (91.6%). Also, 69.5% were willing to come for multiple PNC visits. Parity was significantly associated with willingness to attend multiple PNC visits. Despite suboptimal knowledge of the components of postnatal care services, postpartum women have a good attitude to postnatal care and are willing to attend scheduled and multiple PNC schedules. However, fewer women wanted the multiple PNC schedules. Health education and quality postnatal care will enhance postpartum surveillance with prompt detection and treatment of maternal and neonatal complications to forestall life-threatening complications or mortality.

Non-partner Violence During Pregnancy and Utilisation of Reproductive Healthcare Services by Women in India: An Application of the Andersen–Newman Behavioural Model

Women’s abuse is a global health problem that erodes their self-esteem and saps their energy. Research evidence for India mainly focusses on use of reproductive healthcare services by women based on their experience of intimate partner violence during pregnancy. We hypothesise that non-partner violence during pregnancy can be equally detrimental for women and their children’s well-being. As this aspect remains unexplored, we investigate the relationship between physical non-partner violence (PNPV) faced by women during pregnancy in India and utilisation of three reproductive healthcare services by them, namely antenatal care, institutional delivery and postnatal checks. Using data from the fourth round of the National Family Health Survey and employing binary multivariable logistic regression models under the framework of the Andersen–Newman Behavioural Model of health services utilisation, we find that women who experience PNPV during pregnancy are significantly more likely to give birth in a medical facility but less likely to make use of postnatal care services. Thus, recognising the connection between violence during pregnancy and the utilisation of maternal health services can enable healthcare and other social support organisations to identify the unique needs of pregnant women experiencing abuse and help in reducing such violence from happening in the first place.

Measuring Coverage of Essential Maternal Postnatal Care Services in the Squatter Settlements of Islamabad Capital Territory in Pakistan.

This study aimed to assess the coverage of essential postnatal maternal care services among women residing in the slums of Islamabad. A community-based, cross-sectional study was conducted to assess the coverage of essential postnatal care (PNC) services. Using random sampling, 416 women living in the squatter settlements of Islamabad Capital Territory were selected as study participants. Data was analyzed by using SPSS version 22. Descriptive statistics were employed to display frequencies for categorical variables, whereas mean, median, and standard deviation were calculated for continuous variables. The analysis of data showed that 93.5 percent of the women utilized postnatal services at least once after delivery. Approximately 9 percent and 4 percent of women received all eight recommended services within 24 h of birth and beyond 24 h of birth, respectively. Effective PNC services were received by only 1 percent of the women. The study revealed that the utilization of effective PNC was very low. The majority of the women delivered in health institutions and received their first PNC checkups, but follow-up for the recommended checkups was very low. These results can help health professionals and policymakers in designing programs and developing efficient strategies that would improve PNC service utilization in Pakistan.

Decomposition analysis of women's empowerment-based inequalities in the use of maternal health care services in Ethiopia: Evidence from Demographic and Health Surveys.

The use of maternal health care services tends to rise with women's empowerment. However, disparities in the use of maternal health care services in Ethiopia that are founded on women's empowerment are not sufficiently addressed. In light of women's empowerment equity stratifier, this study seeks to assess inequalities in the uptake of maternal health care services (early antenatal care, four or more antenatal care and postnatal care services). Drawing on data from the four rounds of Ethiopia Demographic and Health Surveys (EDHSs) conducted between 2000 and 2016, we conducted analysis of inequalities in utilization of maternal health care services using women's empowerment as equity stratifier. We utilized concentration index and concentration curve for assessing the inequalities. We used clorenz and conindex Stata modules to compute the index and curve. Decomposition of the Erreygers normalized concentration index was done to explain the inequalities in terms of other variables' percent contributions. Complex aspect of the EDHSs data was considered during analysis to produce findings consistent with the data generating process. All analyses were done using Stata v16. Utilization of maternal health care services was inequitably distributed between empowered and poorly empowered women, with women in the highly empowered category taking more of the services. For instance, the Erreygers index for quality ANC are 0.240 (95% CI 0.207, 0.273); 0.20 (95% CI 0.169, 0.231) and 0.122 (95% CI 0.087, 0.157), respectively, for the attitude towards violence, social independence and decision-making domains of women's empowerment. Inequalities in the distribution of other variables like wealth, education, place of residence and women's empowerment itself underpin the inequalities in the utilization of the services across the women's empowerment groups. Equity in maternal health care services can be improved through redistributive policies that attempt to fairly distribute the socioeconomic determinants of health such as wealth and education between highly and poorly empowered women.

Uptake of, barriers and enablers to the utilization of postnatal care services in Thyolo, Malawi

BackgroundPostnatal care (PNC) ensures early assessments for danger signs during the postpartum period and is to be provided within 24 h of birth, 48–72 h, 7–14 days, and six weeks after birth. This study assessed the uptake of and the barriers and facilitators to receiving PNC care among mothers and babies.MethodsA concurrent mixed-method study employing a retrospective register review and a qualitative descriptive study was conducted in Thyolo from July to December 2020. Postnatal registers of 2019 were reviewed to estimate the proportion of mothers and newborns that received PNC respectively. Focus Group Discussions (FGDs) among postnatal mothers, men, health care workers, and elderly women and in-depth interviews with midwives, and key health care workers were conducted to explore the barriers and enablers to PNC. Observations of the services that mothers and babies received within 24 h of birth, at 48–72 h, 7–14 days, and six weeks after birth were conducted. Descriptive statistics were tabulated for the quantitative data using Stata while the qualitative data were managed using NVivo and analysed following a thematic approach.ResultsThe uptake of PNC services was at 90.5%, 30.2%, and 6.1% among women and 96.5%, 78.8%, and 13.7% among babies within 48 h of birth, 3 to 7 and 8 to 42 days respectively. The barriers to PNC services included the absence of a baby or mother, limited understanding of PNC services, lack of male involvement, and economic challenges. Cultural and religious beliefs, advice from community members, community activities, distance, lack of resources, and poor attitude of health care workers also impeded the utilisation of PNC services. The enablers included the mother’s level of education, awareness of the services, economic resources, community-based health support, adequacy and attitude of health workers, seeking treatment for other conditions, and other clinic activities.ConclusionOptimisation of uptake and utilization of PNC services for mothers and neonates will require the involvement of all stakeholders. The success of PNC services lies in the communities, health services, and mothers understanding the relevance, time points, and services that need to be delivered to create demand for the services. There is a need to assess the contextual factors for a better response in improving the uptake of PNC services and in turn inform the development of strategies for optimizing the uptake of PNC services.

Accessibility Analysis of Childbirth Service Centers Using Geospatial Techniques in Rural Magadi, Kenya

Accessibility to childbirth services is a necessity despite geographic, demographic and socio-economic origin. The distribution pattern between health facilities and households in rural areas is not as extensively researched as those of urban areas, especially pastoral communities. Challenges in accessing social amenities including childbirth service centres are dominant. This study aims to assess the spatial accessibility between the location of households and the location of the childbirth health facility in Magadi Ward. The study employed geospatial techniques to visualize the spatial distribution of households and health facilities; and the road connectivity between them. To represent the variation, accessibility zones were modelled using the Euclidean distance tool. Buffer analysis was also conducted to indicate the relationship between the served and unserved areas in regard to the five kilometres Ministry of Health recommended radius. Coordinates of 246 households were randomly picked from the eight community unit clusters in the Magadi ward. The findings revealed the number of women who delivered at health facilities to be 38.2%, while those who delivered at home were 61.8% contrary to the majority being within the service area of the buffer. The most accessible zones were located in the central and upper western parts of Magadi Ward. The utilization of antenatal and postnatal care services and health facilities for the place of delivery differed significantly. The results indicate the poor use of health facilities as a place of delivery for women who utilized childbirth services in the last year, prior to data collection. This provides valuable information and location-based evidence of low access to health facilities for childbirth services, and therefore, offers guidance on sound decision making and strategies to improve on the accessibility of childbirth services.

Postnatal care services use by mothers: A comparative study of defaulters versus attendees of postnatal clinics in Enugu.

Despite much emphasis on the reproductive health of women, maternal mortality is still high, especially in postnatal period. To assess the prevalence of postnatal care use and reasons for defaults among mothers attending the child immunization clinics in Enugu, Nigeria. This was a cross-sectional comparative study of 400 consecutive nursing mothers who presented at the Institute of Child Health of UNTH and ESUTH, Enugu for Second dose of the Oral Polio Vaccine (OPV2) for their babies at 10 weeks postpartum. Data was collected using Interviewer-administered questionnaire and subsequently analyzed with version 22.0 IBM SPSS software, Chicago, Illinois. A p-value of less than 0.05 was considered as statistically significant. The prevalence of the 6th week postnatal clinic attendance among the mothers was 59%. The majority of the women (60.6%) who had antenatal care by skilled birth attendants attended postnatal clinic. Unawareness and being healthy were the main reasons for not attending postnatal clinic. Following multivariate analysis, place of antenatal (OR = 2.870, 95% C.I = 1.590-5.180, p < 0.001) and mode of delivery (OR = 0.452, 95% C.I = 0.280-0.728, p = 0.001) were the only significant predictors of postnatal clinic attendance (p < 0.05). Postnatal clinic attendance by women in Enugu is still suboptimal. The main reason for non-attendance of the 6th week postnatal clinic was lack of awareness. There is need for healthcare professionals to create awareness about the importance of postnatal care and encourage mothers to attend.

The Role of Organized Public Forums in Improving Uptake of Skilled Birth Attendants among Women of Reproductive Age in Kilifi County, Kenya

The skilled and competent attendant is vital in curbing maternal and infant mortality. Promoting the utilization of maternal health services supervised by skilled health professionals greatly aids in bridging the gap in accessing maternal health services such as immunization and postnatal care services. This lack of skilled attendance is one of the major factors responsible for the rising maternal and infant mortality. Thus, there’s still needed to encourage these women to seek out the services of skilled health professionals during childbirth. This study is aimed at investigating the use of an organized public forums approach in influencing the uptake of skilled birth attendants (SBAs) among women of reproductive age in the Kanamai Area, Kilifi County. The study was conducted at Kanamai Area, Kilifi County. A cross-sectional survey was carried out using semi-structured questionnaires as tools of data collection. Simple random sampling was used to recruit the study participants. All analyses were done using R for Windows (version 4.0.3). Both descriptive and inferential analyses were done. Descriptive statistics were used to generate frequency and percentages, while chi-square was used to draw inferences. Association was considered significant if 𝑃 &lt; 0.05. Some of the notable significant factors gathered through our public forum engagement influencing support for delivery assisted by skilled birth attendants (SBAs) were education level, occupation, and parity. There’s a need for the concerned agencies to embrace the use of public forums and other relevant approaches so as to sought out and promote the rate of health services utilization. Keywords: SBAs, Childbirth, Utilization, Health Facilities, Public Forum.

Exploring areas of improvement in postnatal care services in a tertiary care hospital in Lahore.

Poor postnatal care can increase morbidity and mortality. This study assessed the current deficiencies in quality of postnatal care provided to mothers in Lady Aitchison hospital, Lahore when compared to WHO standards and identifies the areas for quality improvement. It is a descriptive cross-sectional study which employs quantitative method to collect and analyze the data. It was conducted to include ninety-six maternities attending the wards of Lady Aitchison Hospital, Lahore during January 2022 to February 2022. Consenting post-partum mothers were selected by random sampling and interviewed by using a structured proforma. Among 96 mothers, 56% were below 25 years of age, 39% had secondary education, with more than one child (71%) and 57% visited for the first time. Majority of mothers, were given medicine timely (82%) and found the attitude (85%) and information (83%) provided by the healthcare workers helpful. Their subjective satisfaction rate with staff was 90%. The main areas of concern were lack of proper examination guidelines and facilities, limited information to mothers regarding neonatal care and substandard interior of hospitals. The statistics on the detailed maternal and neonatal examination showed that it was left out in 30% to 50% patients. Information regarding the danger signs of mothers and neonates was not given in 69% and information on family planning was provided to only 28%. Contentment with the infrastructure of the hospital was subpar and it was suggested that the sanitary conditions of washrooms and the paraphernalia of the wards i.e., ACs and beds needed improvement. This study suggests that in developing countries like Pakistan, majority of the patients were satisfied by the services of healthcare workers. The prime improvement area is the infra-structure of the hospital which can be upgraded to provide better quality facilities in terms of air-conditioning, washrooms and well-designed areas for extensive examination of breast, pelvis, abdomen and neonates. There is also need for introduction of standard guidelines for postnatal care.

Women’s experiences and views on early breastfeeding during the COVID-19 pandemic in Norway: quantitative and qualitative findings from the IMAgiNE EURO study

BackgroundLittle is known about women’s experience of care and views on early breastfeeding during the COVID-19 pandemic in Norway.MethodsWomen (n = 2922) who gave birth in a facility in Norway between March 2020 and June 2021 were invited to answer an online questionnaire based on World Health Organization (WHO) Standard-based quality measures, exploring their experiences of care and views on early breastfeeding during the COVID-19 pandemic. To examine associations between year of birth (2020, 2021) and early breastfeeding-related factors, we estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multiple logistic regression. Qualitative data were analysed using Systematic Text Condensation.ResultsCompared to the first year of the pandemic (2020), women who gave birth in 2021 reported higher odds of experiencing adequate breastfeeding support (adjOR 1.79; 95% CI 1.35, 2.38), immediate attention from healthcare providers when needed (adjOR 1.89; 95% CI 1.49, 2.39), clear communication from healthcare providers (adjOR 1.76; 95% CI 1.39, 2.22), being allowed companion of choice (adjOR 1.47; 95% CI 1.21, 1.79), adequate visiting hours for partner (adjOR 1.35; 95% CI 1.09, 1.68), adequate number of healthcare providers (adjOR 1.24; 95% CI 1.02, 1.52), and adequate professionalism of the healthcare providers (adjOR 1.65; 95% CI 1.32, 2.08). Compared to 2020, in 2021 we found no difference in skin-to-skin contact, early breastfeeding, exclusive breastfeeding at discharge, adequate number of women per room, or women’s satisfaction. In their comments, women described understaffed postnatal wards, early discharge and highlighted the importance of breastfeeding support, and concerns about long-term consequences such as postpartum depression.ConclusionsIn the second year of the pandemic, WHO Standard-based quality measures related to breastfeeding improved for women giving birth in Norway compared to the first year of the pandemic. Women’s general satisfaction with care during COVID-19 did however not improve significantly from 2020 to 2021. Compared to pre-pandemic data, our findings suggest an initial decrease in exclusive breastfeeding at discharge during the COVID-19 pandemic in Norway with little difference comparing 2020 versus 2021. Our findings should alert researchers, policy makers and clinicians in postnatal care services to improve future practices.

The Factors Associated with Utilization of Postnatal Care Service in Sheka Zone, South-West Ethiopian Peoples Region

Within the first month of life, most deaths of mothers and infants occur. Within the first 24 hours, about half of all maternal deaths occur. In the Sheka zone, southwest of the Ethiopian Peoples area, the study sought to investigate the parameters associated with postnatal care service consumption. From January 2021 to March 2022, a cross-sectional study based in the community was carried out. 1779 individuals in all were enrolled in the study. Variables having a bivariate logistic regression p-value of less than 0.25 were included in the multivariate logistic regression model as statistically significant variables. A P-value of less than 0.05 was used to indicate statistical significance. In the first six weeks after giving birth, this survey found that 54.9% of women used at least one postnatal care service. The vast majority of women who had four or more antenatal visits in the first six weeks accessed postpartum care services (68.48 %) Women who had four or more prenatal visits were 1.834 times more likely to receive postpartum care in the first six weeks than those who had fewer visits (AOR=1.834, 95% CI=1.413-2.380). Compared to women who give birth at home, those who give birth in medical facilities are more likely to receive postpartum care (AOR=1.473, 95% CI=1.163-1.867). Compared to other age groups, women between the ages of 20 and 24 were more likely to receive postpartum care (AOR=3.570, 95% CI=2.419-5.268). Women who attended Elementary school (AOR=2.356, 95% CI=1.717-3.233) and Secondary and above School (AOR=1.690, 95% CI=1.174-2.431) were more likely to receive Postnatal Care services than uneducated women. Women who had a job were more likely to receive Postnatal care than hadn’t job women (OR=5.857, 95% CI=14.013-8.549). Married women were more likely to receive Postnatal care services than Never married women (AOR=1.572, 95% CI=1.149-2.149). Women who gave birth to twins were more likely to receive Postnatal Care than women who gave birth to a child (AOR=0.360, 95% CI=0.250-0.519). This study showed that postnatal care services were underutilized in the Sheka Zone, Southwest Ethiopian People Regions. The utilization of postnatal care services will therefore rise if routine antenatal care is encouraged to be followed by institutional delivery along with integrated health education about postnatal care both during pregnancy and delivery. The research area's government and stakeholders should arrange skill development for using postnatal care.

Colostrum avoidance practice and associated factors among mothers of infants less than six months in Chencha District: cross-sectional study

BackgroundColostrum avoidance is failure to feed first breast milk to a newborn baby for the first 2 to 3 days after delivery. The problem of avoiding colostrum is prevalent in Ethiopia. But it is not adequately addressed yet. Therefore, the purpose of this study was to assess prevalence of colostrum avoidance practices and associated factors among mothers of infants aged less than six months; and to explore barriers for colostrum feeding in ChenchaZuria District.MethodsA community-based cross-sectional study supplemented with a qualitative study was conducted in August 2020. The quantitative data were collected from 674 mothers selected by systematic sampling using a structured questionnaire. Both bi-variable and multi-variable binary logistic regression analysis was used to identify factors associated with the colostrum avoidance practices. The statistical significance was declared at a p-value < 0.05. The qualitative data were collected using in-depth interviews from breastfeeding mothers and thematic analysis was done manually.ResultThe prevalence of the colostrum avoidance practice was 15.3% (95% CI: 11.4%- 18.2%). Late initiation of breastfeeding (AOR 4.15 95% CI 2.51–6.84), giving pre-lacteal feeding (AOR 3.16 95% CI 1.93–5.15), not using of postnatal care (PNC) service (AOR 1.79 95% CI 1.05–3.04), and having poor maternal knowledge regarding colostrum. (AOR 1.88 95% CI 1.14–3.08) were factors significantly associated with the colostrum avoidance practices. And in the qualitative part, cultural beliefs and misconceptions, community influence, and complementary feeding practices were found to be facilitators for the colostrum avoidance.ConclusionAbout one in seven mothers practiced colostrum avoidance. Factors that contributed to the colostrum avoidance practices were breastfeeding initiation, pre-lacteal feeding, PNC utilization, and maternal knowledge regarding colostrum. Thus, efforts to prevent colostrum avoidance practices should focus on strengthening and promoting PNC services utilization, timely initiation of breastfeeding, and improving awareness creation activities on the importance of colostrum feeding and risks of pre-lacteal feeding.

Male partner involvement in postnatal care service utilization and associated factors: A community-based cross-sectional study in Motta district, Northwest Ethiopia.

Male partner involvement during the postpartum period is an effective strategy to improve maternal and newborn health outcomes. However, since reproductive health has been viewed as only a woman's issue, it remains a major challenge in developing countries, including Ethiopia. The current study aimed to assess male partner involvement in postnatal care service utilization and associated factors in the Motta district of North West Ethiopia in 2020. A community-based cross-sectional study was conducted from March 16 to 30, 2020, among male partners whose wives gave birth in the last twelve months in Motta district. A systematic random sampling technique was used to obtain 612 study participants. Data entry was carried out by using Epi Data version 3.1 and exported to Statistical Package of Social Science version 23 for analysis. A binary and multiple logistic regression method were employed to estimate the crude and adjusted odds ratios with a confidence interval of 95% and a P value of less than 0.05 were considered statistically significant. The findings from this study highlight that the overall male partner involvement in postnatal care service utilization was 20.8% at 95%CI (17.6%, 24.1%). The regression results indicated that male partners residing in urban areas, attending primary and secondary education, having good knowledge of postnatal care services, having good knowledge of danger signs and complications during the postnatal period, having a favorable attitude toward male partner involvement in postnatal care, and a short distance to health care facilities were shown to be significantly and positively associated with male partner involvement in postnatal care services. The magnitude of male partner involvement in postnatal care service utilization was low as compared to other studies. Community-based awareness creation through health education and expanding educational and health care service institutions are essential to increase the involvement of male partners in postnatal care services.

Postnatal care services in rural Zambia: a qualitative exploration of user, provider, and community perspectives on quality of care

BackgroundPostnatal care (PNC) is an important set of services offered to the mother and her newborn baby immediately after birth for the first six weeks to prevent maternal and neonatal complications and death. This qualitative study explored user and provider perspectives on quality of PNC services in the selected health facilities within the context of the Maternity Homes Access in Zambia project in the Saving Mothers Giving Life districts in rural Zambia.MethodsBetween October 2018 and February 2019, forty focus group discussions (FGDs) (n = 160 participants) and twelve in-depth interviews (IDIs) were conducted in four districts in Southern and Eastern provinces. FGDs comprised women who delivered within the last year, fathers, community elders, and volunteers. IDIs comprised health workers at facility, district, and provincial levels. Data were analysed using content analysis guided by the international quality of care domains derived from the World Health Organization quality of care framework. Findings were triangulated to understand perceptions.ResultsOverall, study participants perceived PNC services to be beneficial. Nevertheless, respondents had mixed feelings on the quality of PNC services and expressed a stark difference in their perception of factors affecting service quality. Service users described challenges arising from ineffective communication about the new PNC guidelines, and non-adherence of service providers to quality standards regarding respect, preservation of dignity and emotional support. Other factors were long waiting hours, small examination rooms providing inadequate privacy, and low levels of confidentiality. In contrast, service providers attributed poor service quality to various health system-related factors including low staffing levels, dysfunctional referral services, low supply of essential medicines, supplies, vaccines and equipment for optimal routine emergency obstetric and newborn care and management of complications.ConclusionThese findings highlight important intervention opportunities to improve quality of PNC services in Zambia through better communication and raising awareness on PNC guidelines, respect, preservation of dignity and emotional support to mothers. Interventions should also focus on addressing contextual health system challenges including staffing levels, supply chain for essential medicines and commodities, shortening waiting time, and ensuring functional referral system.

Is Women's Engagement in Women's Development Groups Associated with Enhanced Utilization of Maternal and Neonatal Health Services? A Cross-Sectional Study in Ethiopia.

In Ethiopia, the Women Development Group program is a community mobilization initiative aimed at enhancing Universal Health Coverage through supporting the primary healthcare services for mothers and newborns. This study aimed to assess the association between engagement in women's groups and the utilization of maternal and neonatal health services. A cluster-sampled community-based survey was conducted in Oromia, Amhara, Southern Nations, Nationalities and Peoples, and Tigray regions of Ethiopia from mid-December 2018 to mid-February 2019. Descriptive and logistic regression analyses were performed, considering the cluster character of the sample. A total of 6296 women (13 to 49 years) from 181 clusters were interviewed. Of these, 896 women delivered in the 12 months prior to the survey. Only 79 (9%) of these women including Women Development Group leaders reported contact with Women Development Groups in the last 12 months preceding the survey. Women who had educations and greater economic status had more frequent contact with Women Development Group leaders. Women who had contact with Women Development Groups had better knowledge on pregnancy danger signs. Being a Women Development Group leader or having contact with Women Development Groups in the last 12 months were associated with antenatal care utilization (AOR 2.82, 95% CI (1.23, 6.45)) but not with the use of facility delivery and utilization of postnatal care services. There is a need to improve the organization and management of the Women Development Group program as well as a need to strengthen the Women Development Group leaders' engagement in group activities to promote the utilization of maternal and neonatal health services.

Factors influencing uptake of postnatal care services at a maternal and child health clinic in Kajiado County Referral Hospital, Kenya

Background/Aims Despite birth aftercare recommendations that a postnatal visit should take place to examine both a woman and her child 6 weeks after birth, use of postnatal care services remains low at the Kajiado County referral hospital. This study's aim was to understand the factors influencing uptake of postnatal care among women of reproductive age. Methods This qualitative study used purposive sampling to select study respondents who were asked to attend focus group discussions to collect data. A total of 12 women were interviewed during their postnatal period. The qualitative data were analysed by theme categorisation. Results Respondents cited low income and forgetfulness, as well as the long distance to travel for postnatal services and long waiting times at the hospital as the main factors hindering attendance at and use of postnatal services. Conclusions Affordable and accessible postnatal care services need to be provided to follow up postnatal mothers, reducing the waiting time for services in postnatal clinics and ensuring women's partners support them to promote postnatal care service use.

Sociodemographic and Maternal Determinants of Postnatal Care Utilization: A Cross-Sectional Study.

Postnatal care (PNC) is critical for the newborn and the mother, as it offers the opportunity to examine the mother and child to ensure early and timely intervention of any obstetric anomalies that might have gone unnoticed during delivery. However, there is a lack of data on PNC utilization and associated determinants in Ghana. Meanwhile, it is suspected that the PNC service should be more patronized by mothers, particularly within the first 2 days after delivery; therefore, investigating PNC utilization and associated factors could inform policies to enhance PNC uptake. The objective is to determine the level of utilization of PNC service and associated factors in the Savannah region of Ghana. The study used a facility-based analytical cross-sectional study design. The study was carried out in 311 postnatal mothers using consecutive sampling. Data collection was carried out using a questionnaire. Univariate and multiple logistic regression was performed to establish the determinants of PNC. Variables/variable categories with P < .05 were significantly associated with PNC. The significance level is anchored at P < .05. The study showed that almost all respondents (98.7%) have heard about PNC services through health workers (39.7%), media (13.0%), and friends and relatives (47.2%). Most of the respondents (88.7%) have used PNC services within 48 h. Mothers aged 25-39 years were about seven times more likely to utilize PNC compared to those who were less than 25 years old (AOR [adjusted odds ratio] = 7.41, 95% CI [confidence interval]: 1.98-7.71); mothers with high school education (SHS) and above were also approximately four times more likely to use PNC compared to those who had no formal education (AOR = 3.65, 95% CI 1.97-13.66). In the same vein, married mothers were 10 times more likely to use PNC compared to those who are single mothers (AOR = 10.34, 95% CI: 3.69-28.97), whereas mothers who had at least four antenatal care (ANC) visits during pregnancy were approximately seven times more likely to use PNC compared to those who had less than four ANC visits (AOR = 6.92, 95% CI: 1.46-32.78). Reasons for not attending PNC include waiting time (40.5%), health workers' attitude (32.4%), being attended by a student (16.2%), being busy (27.0%), inadequate information on PNC (24.3%), and no family support (18.9%). All mothers knew about the PNC services, with a higher proportion patronizing the services. The increasing age, the level of mothers, marital status, and participation in ANC were significant determinants of the use of PNC. More education during ANC on the importance of PNC service is required to achieve universal coverage of PNC.

Determinants of early interruption of exclusive breastfeeding at Dollo Ado refugee camps, Dollo Ado district, Ethiopia.

nearly three-quarters of infants younger than six months were not exclusively breastfed globally. Despite some research indicating what factors influence early exclusive breastfeeding interruption in Ethiopia's stable population, there is little evidence indicating what factors influence exclusive breastfeeding interruption in vulnerable populations such as refugee camps. Therefore, this study aimed to determine the factors that contributed to the early termination of exclusive breastfeeding in Ethiopian refugee camps in the Dollo Ado district. a case-control study was conducted at the Dollo Ado refugee camps from April 05th to 25th, 2017. The eligible 112 cases and 224 controls were identified using the 24-hour recall method. The information was gathered using an interviewer-administered questionnaire that was pretested and organized. Logistic regression analysis was computed to assess the effect of independent variables. the determinants for early interruption of exclusive breastfeeding were not counseled about infant feeding during antenatal care follow-up (adjusted odds ratio (AOR =5.87, 95% CI [2.61-13.1]), not counseled about infant feeding during postnatal care service use (AOR= 4.33, 95% CI [2.71-10.8), breastfeeding problem (AOR= 5.62, 95% CI [4.55-15.2]) and late initiation of breastfeeding (AOR= 4.79, 95% CI [28-10.1]). in this study, early termination of exclusive breastfeeding was caused by breastfeeding problems and late commencement of breastfeeding, as well as not receiving infant feeding advice during antenatal care or postnatal care. The results of this study highlight the significance of concentrating on newborn and young child feeding counseling during prenatal and postnatal care services in order to promote exclusive breastfeeding. In addition, health providers should educate parents on the significance of starting exclusive breastfeeding on time and obtaining help right away if there is a problem, such as breast soreness or the infant refusing to eat due to oral trash, to avoid early exclusive breastfeeding interruption.

Effect of Perceived Factors on the Utilisation of Postnatal Care Services by Nursing and Postpartum Mothers in Gwer-East Local Government Area of Benue State, Nigeria.

Introduction: This study assessed the effect of perceived factors on the utilisation of postnatal care services by nursing and postpartum mothers in Gwer-East Local Government Area of Benue State. Five objectives were set in the study. Five research questions and five hypotheses were postulated to guide the study. Methodology: The study employed a descriptive survey research design. The population of the study comprised all the nursing mothers attending routine immunisation or other healthcare services with their children in Gwer-East Local Government Area. Total Population Sampling technique was used in the study to sample 198 nursing mothers for the study. The instrument used for data collection was a structured questionnaire designed by the researcher and titled Utilisation of Postnatal Care Services Questionnaire (UPCSQ). Data for this research was obtained through the administration of the questionnaire on respondents. Hand delivery method was used for both the distribution and collection of the questionnaires. The researcher used binary logistic regression to analyse the data at 0.05 level of significance. Results: age [15 – 25 yrs (aOR:8.0, 95%CI: 4.2 – 44.2, p&lt;0.05); 26 – 35 yrs (aOR:6.7, 95%CI: 4.5 – 16.9, p&lt;0.05); 36 – 45 yrs (aOR:2.8, 95%CI: 0.8 – 10.2, p&lt;0.05)]; place of residence [Rural (aOR:0.36, 95%CI: 0.01 – 0.12, p&lt;0.05)]; employment status [unemployed (aOR:0.192, 95%CI: 0.079 –.465, p&lt;0.05); Employed (aOR: 1.117, 95%CI: 0.525 – 2.378, p&gt;0.05); Contract Worker (aOR: 1.203, 95%CI: 0.481 – 3.012, p&gt;0.05)]; level of education [No Formal (aOR:0.001, 95%CI: 0.00 – , p&gt;0.05); Primary (aOR:0.85, 95%CI: 019 – .379, p&lt;0.05); Secondary (aOR:0.220, 95%CI: 0. 084 – .576, p&lt;0.05)]; level of income [Low (aOR:0.032, 95%CI: 0.010 – 0.105, p&lt;0.05); Middle (aOR:0.66, 95%CI: 0.029 – 1.151, p&lt;0.05)] have a significant effect on utilisation of postnatal care services by postpartum mothers. Recommendations: Government effort to strengthen postnatal care utilisation should focus on universal coverage by addressing financial barriers to vulnerable groups, quality improvement to increase women’s satisfaction and carry the less privilege along and integration programmes to maximize the contact between women and health care services during and after delivery and to enhance economic development. Index Terms: Utilisation, Postnatal Care Services, Nursing Mothers, Postpartum Mothers, Perception.

Prevalence of early postnatal care services usage and associated factors among postnatal women of Wolkite town, Gurage zone, Southern Ethiopia: a community-based cross-sectional study

ObjectiveEarly postnatal care service usage in developing countries is one of the healthcare service usage problems among postnatal women, which is related to extensive maternal and neonatal complications and mortality....