A review of factors associated with the utilization of healthcare services and strategies for improving postpartum care in Africa

Belemsaga, Danielle Yugbaré; Kouanda, Séni; Goujon, Anne; Kiendrébéogo, Joël Arthur; Duysburgh, Els; Degomme, Olivier; Temmerman, Marleen

doi:10.21825/af.v28i2.4866

Cited by 15 publications

(21 citation statements)

References 57 publications

(195 reference statements)

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“…Young mothers more likely utilize postnatal care service than older one. This finding is supported by local studies conducted in Wolayitta Zone, SNNPR [11], and in addition it is similar with a study conducted in Pakistan [16], from a review on African country [17]. This can be justified younger mothers are more likely to have greater exposure and more access to education.…”

Section: Discussionsupporting

confidence: 87%

Postnatal Care Service Utilization and Associated Factors among Mothers Who Delivered in Shebe Sombo Woreda, Jimma Zone, Ethiopia

Chemir¹,

Melkamu²,

Sinaga³

2018

Int J Women's Health Wellness

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Background: Postnatal care is a critical period for both mothers and newborns survival. But, post-natal care is yet neglected; little attention and an effort have been paid by health care providers and policy makers in developing countries. Post-natal care service utilization is still low and maternal mortality rate is high. However, studies on postnatal care service utilization and associated factors are lacking in the study setting. Therefore, the aim of this study is to assess postnatal care service utilization and associated factors among mothers who delivered in Shabe sombo woreda, Jimma zone, Oromiya region, South West Ethiopia, 2018. Methods: A community based cross-sectional study design was conducted in Shabe sombo woreda, Jimma zone. A total of 564 study participants were included in the study using simple random sampling technique. Data was collected from March 1-April 1, 2018. Data was entered into Epi data version 3.1 and exported into SPSS version 23.0 for analysis. Bivariate and multivariable logistic regression analysis was made in order to predict factors associated with postnatal care (PNC) service utilization. Result: The study revealed that the magnitude of PNC service utilizations is 58.5%. Multivariable logistic regression analysis showed that, mothers with younger age (adjusted odds ratio (AOR) = 2.243, (95% CI: 1.066, 4.721), having antenatal care visit (AOR = 9.36, 95% CI: 5.605, 15.618), experiencing obstetric complication during pregnancy (AOR = 2.3373, 95% CI: 1.095, 5.142), who had information about PNC (AOR = 9.946, 95% CI: 6.009, 16.460) and appointed for PNC follow-up (AOR = 2.114, 95% CI: 1.289, 3.466) were more likely to utilize postnatal care services. Conclusion: Though the finding showed that postnatal care service utilization was high when compared to other studies done in country, it was a lot behind from the national target of postnatal care service utilization in Ethiopia. The initiative of provision of information, education, counseling and communication both at the community and facility level should be strengthened.

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Section: Discussionsupporting

confidence: 87%

Postnatal Care Service Utilization and Associated Factors among Mothers Who Delivered in Shebe Sombo Woreda, Jimma Zone, Ethiopia

Chemir¹,

Melkamu²,

Sinaga³

2018

Int J Women's Health Wellness

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“…In LMICs, the lack of a pre-discharge check may partly be a result of inadequate staffing, particularly in lower-level facilities, where odds of receiving the check were lower because providers are busy assisting other women in labor or with complications [15,37]. Already overburdened or burned-out staff [38] may see postpartum care and pre-discharge checks as a less important priority compared to providing antenatal and intrapartum services [11].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the current literature on coverage and quality of postpartum care focuses on women who gave birth outside of health facilities and on their newborn [11–13]. Much less is known about the quality of care for women within health facilities during the immediate postpartum period before discharge.…”

Section: Introductionmentioning

confidence: 99%

Provision of postpartum care to women giving birth in health facilities in sub-Saharan Africa: A cross-sectional study using Demographic and Health Survey data from 33 countries

et al. 2019

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BackgroundPostpartum care has the potential to avert a substantial proportion of maternal and perinatal mortality and morbidity. There is a crucial gap in understanding the quality of postpartum care for women giving birth in health facilities in low- and middle-income settings. This is particularly the case in sub-Saharan Africa (SSA), where the levels of maternal and neonatal mortality are highest globally despite rapid increases in facility-based childbirth. This study estimated the percentage of women receiving a postpartum health check following childbirth in a health facility in SSA and examined the determinants of receiving such check.Methods and findingsWe used the most recent Demographic and Health Survey (DHS) conducted in 33 SSA countries between 2000–2016. We estimated the percentage of women receiving a postpartum check by a health professional while in the childbirth facility and the associated 95% confidence interval (CI) for each country. We analyzed determinants of receiving such checks using logistic regression of the pooled data. The analysis sample included 137,218 women whose most recent live birth in the 5- year period before the survey took place in a health facility. Of this pooled sample, 65.7% of women were under 30 years of age, 85.9% were currently married, and 57% resided in rural areas. Across countries, the median percentage of women who reported receiving a check was 71.7%, ranging from 26.6% in Eswatini (Swaziland) to 94.4% in Burkina Faso. The most fully adjusted model showed that factors from all four conceptual categories (obstetric/neonatal risk factors, care environment, and women’s sociodemographic and child-related characteristics) were significant determinants of receiving a check. Women with a cesarean section had a significantly higher adjusted odds ratio (aOR) of 1.88 (95% CI 1.72–2.05, p < 0.001) of receiving a check. Women giving birth in lower-level public facilities had lower odds of receiving a check (aOR 0.94, 95% CI 0.90–0.98, p = 0.002) compared to those in public hospitals, as did women attended by a nurse/midwife (compared to doctor/nonphysician clinician) (aOR 0.74, 95% CI 0.69–0.78, p < 0.001). This study was limited by the accuracy of the respondent’s recall of the provider, timing, and receipt of postpartum checks. The outcome of interest was measured using three slightly different question sets across the 33 included countries.ConclusionsThe suboptimal levels of postpartum checks in health facilities in many of the included SSA countries partially reflect the lack of importance given to postpartum care in the global discourse on essential interventions and quality improvement in maternal health. Addressing disparities in access to both facility-based childbirth and good-quality postpartum care in SSA is critical to addressing stalling declines in maternal mortality and morbidity.

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“…Despite its importance, it is the most neglected maternal health service particularly in developing countries [6][7][8][9]. The Demographic and Health Survey (DHS) results of different African countries indicated that only 36% of women had a postnatal visit within 2 days [10] but, it was much less in Ethiopia which was 17% according to 2016 EDHS [11].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with postnatal care utilization among postpartum women in Ethiopia: a multi-level analysis of the 2016 Ethiopia demographic and health survey

et al. 2020

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Background: Most postpartum women and newborns do not utilize postnatal care due to less emphasis given especially in developing countries. Understanding individual and community-level factors associated with postnatal care will help to design appropriate strategies and policies for improving service utilization. Therefore, this study aimed to assess individual and community-level factors associated with postnatal care utilization in Ethiopia.Method: This study used the Ethiopian Demographic and Health Survey (EDHS) data of 2016. A total of 4489 women who gave birth 2 years before the survey were included. Two-stage stratified cluster sampling technique was used. The analysis was done using Stata version 14.0 after checking for basic assumptions of multilevel logistic regression. Multilevel mixed-effects logistic regression was used to identify determinants of postnatal care utilization. An adjusted odds ratio with a 95% confidence interval was used to show the strength and direction of the association. Results: Husband with secondary education [AOR = 0.17, 95% CI = (0.04, 0.68)], four or more antenatal care visit [AOR = 10.77, 95% CI = (2.65, 43.70)], middle wealth quintile [AOR = 3.10, 95% CI = (1.12, 8.58)] were individual level factors. Community level education [AOR = 2.53, 95% CI = (1.06, 6.06)] and community level of health service utilization [AOR = 2.32, 95% CI = (1.14, 4.73)] were the predictors at community level.Conclusion: Wealth index, number of antenatal care visits, husband education, community level of education and health service utilization were significantly associated with PNC service utilization. Provision of quality antenatal care, improvement of the educational status of women and husband involvement in PNC are important strategies to increase PNC service utilization.

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A review of factors associated with the utilization of healthcare services and strategies for improving postpartum care in Africa

Cited by 15 publications

References 57 publications

Postnatal Care Service Utilization and Associated Factors among Mothers Who Delivered in Shebe Sombo Woreda, Jimma Zone, Ethiopia

Postnatal Care Service Utilization and Associated Factors among Mothers Who Delivered in Shebe Sombo Woreda, Jimma Zone, Ethiopia

Provision of postpartum care to women giving birth in health facilities in sub-Saharan Africa: A cross-sectional study using Demographic and Health Survey data from 33 countries

Factors associated with postnatal care utilization among postpartum women in Ethiopia: a multi-level analysis of the 2016 Ethiopia demographic and health survey

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