Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

Baldé, Mamadou Diouldé; Diallo, Aissatou; Soumah, Anne Marie; Sall, Alpha Oumar; Diallo, Boubacar Alpha; Barry, Fanta; Touré, Amadou Oury; Barry, Alpha Amadou; Camara, Sadan

doi:10.4236/ojog.2021.114039

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…In the sensitivity analysis (Supplementary file 1 ), belonging to richer wealth quintile was significantly associated with increased utilisation of PNC services, a finding similar to studies done in Guinea, Zambia and Ethiopia [ 29 , 34 , 46 , 53 ]. Wealth index being a proxy of financial status means that women in higher wealth indices can easily afford the direct and indirect costs involved in accessing quality and timely healthcare [ 54 , 55 ].…”

Section: Discussionsupporting

confidence: 76%

“…It is widely reported that empowering women to individually take decisions concerning their maternal health demands has greatly shown positive impact in the utilisation of services like PNC [ 37 ]. The influence of spouses and family members in the women’s decision making towards seeking health care services has been documented elsewhere as a key factor limiting utilisation of services like PNC [ 31 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Sserwanja¹,

Nuwabaine²,

Kamara

et al. 2022

BMC Public Health

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Background Within 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. Methods We 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. Results Out 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. Conclusion Factors 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.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Sserwanja¹,

Nuwabaine²,

Kamara

et al. 2022

BMC Public Health

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“…However, barriers were markedly observed in low-and middle-income countries where postnatal care utilization was low at village levels and where 70% of the mothers were settled down [39]. Financial constraints, distance from the health center, poor programming for postnatal care, women's experience during childbirth, cultural constraints, mother and family members' health literacy on postnatal care, feeling that postnatal visits were not necessary, sociocultural beliefs, and practices, whichhindered mothers from utilizing postnatal care and from having adequate nutritional intake during the postnatal period [39,40]. Other factors were related to the health system such as insufficient staff, poor reception of clients, lack of trust and confidentiality between clients and health care providers, lack of sensitization and information, and midwives' workloads [41].…”

Section: Barriersmentioning

confidence: 99%

Perspective Chapter: Contemporary Challenges in Postnatal Care in Low- and Middle-Income Countries

A. Bawazir

2024

Contemporary Challenges in Postnatal Care

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The postnatal phase is the first six weeks after delivery and is a critical time for mothers, newborns, and other caregivers as a highly neglected phase of a transition period. Almost all maternal and neonatal deaths occur in low- and middle-income countries, where fewer services are provided for mothers after the delivery period, which constitutes a tremendous challenge facing mothers in these countries. Barriers were markedly observed in low-and middle-income countries as a result of financial constraints, distance from the health center, poor programming for postnatal care, negative childbirth experiences, and cultural constraints. Moreover, the unproper advocacy of contraceptive use during the postpartum period impacts prolonged interpregnancy intervals and indirectly increases postpartum complications mainly in low- and middle-income countries. The importance of the quality of postnatal care was frequently addressed to answer the required interventions that should be implemented at the level of healthcare facilities, household, and community levels as part of the process of reducing the impact of postnatal complications, disabilities, and maternal mortality.

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“…Several factors were associated with the uptake of PNC including wealth, mother’s education, uptake of antenatal care, place of delivery and access to media [ 8 , 9 , 11 ]. PNC is especially not received among those residing in rural community, with barriers in receiving PNC included limited access to services, lack of health literacy, and sociocultural beliefs [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Early postnatal care contact within 24 hours by skilled providers and its determinants among home deliveries in Myanmar: Further analysis of the Myanmar Demographic and Health Survey 2015–16

et al. 2023

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Background Access and use of early postnatal care (PNC) by skilled providers are crucial for reducing maternal and newborn deaths. However, use of PNC among the deliveries by skilled providers in some developing countries remains unsatisfactory. Furthermore, literature concerning PNC among home deliveries remains limited, particularly in resource-limited countries such as Myanmar. This study aimed to estimate the prevalence of having early PNC contact by skilled providers and its determinants among home deliveries in Myanmar. Methods This cross-sectional study used secondary data from the Myanmar Demographic and Health Survey 2015–16. We included information on all home deliveries in the interviewed mothers aged 15–49 years in the 2 years preceding the survey. Early PNC attendance and its determinants were assessed (using modified Poisson regression with robust variance estimates). All analyses were performed using STATA, Version 15. A p-value <0.05 was considered statistically significant. Results Of a total of 2,129 home deliveries, 36.1% (95%CI: 32.4%, 39.9%) did not receive PNC from any providers. Among all home deliveries included in this study, 468 (22.0%, 95%CI: 19.1%, 25.1%) received early postnatal checkup within 24 hours by skilled providers (doctors/nurses/midwives/Lady Health Visitors). Factors associated with early PNC contact among home deliveries by skilled providers included possessing higher education (adjusted Prevalence Ratio (aPR: 1.40, 95%CI: 1.01, 1.94), resident from coastal regions (aPR:1.37, 95%CI: 1.04, 1.80), currently married (aPR: 1.87, 95%CI: 1.01, 3.49), attaining antenatal care (ANC) at least four times (aPR:1.47, 95%CI: 1.22, 1.77), giving birth by a skilled birth attendant (aPR:8.80, 95%CI: 6.67, 11.61), and having access to mass media at least once weekly (aPR:1.23, 95%CI: 1.03, 1.46). Conclusion A high percentage of home deliveries (78%) were not receiving early PNC by skilled providers. To facilitate early and safe PNC, expanding the coverage of skilled birth attendants and promoting the utilization of ANC should be strengthened. Targeted health education should be delivered through mass media especially for those with low education levels residing in delta, lowland, hills and plains.

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Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

Cited by 5 publications

References 26 publications

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Perspective Chapter: Contemporary Challenges in Postnatal Care in Low- and Middle-Income Countries

Early postnatal care contact within 24 hours by skilled providers and its determinants among home deliveries in Myanmar: Further analysis of the Myanmar Demographic and Health Survey 2015–16

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