BackgroundPostnatal care service enables health professionals to identify post-delivery problems including potential complications for the mother with her baby and to provide treatments promptly. In Ethiopia, postnatal care service is made accessible to all women for free however the utilization of the service is very low. This study assessed the utilization of postnatal care services of urban women and the factors associated in public health facilities in Mekelle city, Tigrai Region, Northern Ethiopia.MethodsA facility based cross sectional study design was used to assess post natal service utilization. Using simple random sampling 367 women who visited maternal and child health clinics in Mekelle city for postnatal care services during January 27 to April 2014 were selected. Data was entered and analyzed using SPSS Version 20.0 software. A binary and multivariable logistic regression was used to identify risk factors associated with the outcome variables. P-value less than 0.05 is used to declare statistical significance.ResultsThe prevalence of women who utilized postnatal care service was low (32.2%). Women who were private employees and business women were more likely to utilize postnatal care services (AOR = 6.46, 95% CI: 1.91–21.86) and (3.35, 95% CI: 1.10–10.19) respectively compared to house wives., Women who had history of one pregnancy were more likely to utilize the service (AOR = 3.19, 95% CI: 1.06–9.57) compared to women who had history of four and above pregnancies. Women who had knowledge of postnatal care service were also more likely to utilize postnatal care service (AOR = 14.46, 95% CI: 7.55–27.75) than women who lacked knowledge about the services.ConclusionsPostnatal care utilization in the study area is low. Knowledge on postnatal care services and occupation of women had positive impact on postnatal care service utilization. The Mekelle city administration health office and other stakeholders should support and encourage urban health extension workers and health facilities to strengthen providing health education to improve the knowledge of the women about the importance of postnatal care services.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0557-5) contains supplementary material, which is available to authorized users.

Health extension workers (HEWs) are the primary implementers of the health extension program (HEP) &ndash; a government-led community-based health-care program, but clinicians are anticipated to play a critical part in providing extensive support, thus, this study aimed to assess clinicians&rsquo; knowledge and perceptions of HEP, a cross-sectional study was conducted with 1239 clinicians. A set of 54-item questions was created based on HEP guidelines and relevant literature. Exploratory factor analysis (EFA) identified latent variables with Eigenvalues matrix >1. Cluster variables were derived through orthogonal varimax factor rotation, and internal reliability was evaluated using Cronbach&rsquo;s alpha coefficient. A composite score was generated for each constructed factor, and the associations between variables were determined using a one-way analysis of variance. Multiple linear regression analysis was conducted to eliminate confounders, with statistical significance set at P < 0.05. EFA provides three factors explaining 91% of the total variance and labeled as &ldquo;clinician-perceived attitude towards the skill of HEWs&rdquo; (F1), &ldquo;clinician knowledge on HEP activities&rdquo; (F2), and &ldquo;clinician-perceived attitude towards the impact of HEP&rdquo; (F3). Internal reliability for the 54 items was 0.96, and it was 0.93, 0.90, and 0.89 for F1, F2, and F3, respectively. 75.5% and 76.2% of clinicians had favorable attitudes toward F1 and F3, respectively, and 70.2% had good knowledge of F2. F1 was positively correlated with participation in HEP review meetings, home visits, HEP outreach, and willingness to work in HEP but negatively correlated with degree holders. F2 was positively correlated with participation in HEP review meetings, home visits, being married, and non-medical doctors but negatively correlated with willingness to work in HEP, older age, female, and degree holder clinicians. Three factors, focusing on knowledge, skill, and the impact of HEP, were found and fall under the second-generation HEP framework. Therefore, strengthening HEP guidelines is essential to ensuring the delivery of sustainable and pro-poor HEP.