Determinants of early postnatal care attendance: analysis of the 2016 Uganda Demographic and Health Survey

Abstract

Background The first two days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first two days after childbirth can help avert maternal mortality because it allows early detection of problems that could result in adverse maternal health outcomes. Unfortunately, knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed at reducing maternal mortality, remains low in Uganda. Therefore, the purpose of this study is to investigate the determinants of early postnatal care attendance among Ugandan women. Methods This study was based on nationally representative data from the 2016 Uganda Demographic and Health Survey. The study sample comprised 5,471 women (age 15–49) who delivered a child in the 2 years preceding the survey. We used logistic regression to identify factors associated with the use of early postnatal care. Results Our findings showed that 50% of mothers used EPNC services for their most recent delivery in the 2 years preceding the survey. Women’s residence, education level, religion, wealth status, marital status, occupation, antenatal care attendance, place of delivery, birth order, perceived accessibility of health facilities, and access to mass media messages were associated with greater use of EPNC. The percentage of women receiving EPNC was much higher among women who delivered at a health facility, either a public facility (63%) or private facility (65%), versus only 9% among women who delivered at home. Multivariate analysis showed that delivery at a health facility was the most important determinant of early postnatal care attendance. Conclusions To increase mothers’ use of EPNC services and improve maternal survival in Uganda, programs could promote and strengthen health facility delivery and ensure that EPNC services are provided to all women before discharge. Even so, the fact that only about two-thirds of women who delivered at a health facility received early postpartum care shows substantial room for improvement. Key words Early postnatal care, Uganda, Demographic and Health Survey, place of delivery

Determinants of postnatal checkup for newborns in Ethiopia: Further analysis of 2016 Ethiopia demographic and health survey

“…Likewise, this study suggested that access to media by mothers has been found to have a positive association with the use of PNC services among the newborn. This finding is in line with studies done in Uttar Pradesh [29], Uganda [27], and Nigeria [28]. This might be explained by mother's who have access to media have been found to have increased antenatal care visits, which enables them to know the benefits of PNC after birth [1].…”

“…Likewise, this study also suggests that newborns whose mothers who had 1-3, and greater than four ANC visits had higher odds of having postnatal checkup of the newborn than those who did not have antenatal care follow up during pregnancy. This finding is in line with studies done in rural Tanzania [15], Uganda [27], Kenya [8], and the Tigray region in Ethiopia [30]. This could be explained that the provision of counseling and health education to mothers by skilled health care providers at the time of ANC follow up is paramount [31].…”

“…In this study, the odds of receiving PNC of the newborn within the 28 days of life were greater among women who had rich and middle wealth classes compared to those mothers who had poor wealth index. This result is reinforced by studies done in India [9], Uganda [27], and Rwanda [13]. The consistency might be for the reason that women who have good wealth status might be autonomous to make a decisions on the use of house hold incomes, and they can also afford payments related to health care service to their newborns and themselves [1,28].…”

“…This could be justified by mothers delivering at a health facility increases the chances of skilled birth attendance, which plays a vital role in ensuring that mothers and newborns receive comprehensive care, including postnatal care soon after delivery. Another possible explanation for this finding is that delivery at a health facility ensures access to emergency obstetric care to deal with complications during labor, which may also expose women and newborns to postnatal care [27].…”

Influence of women’s empowerment indices on the utilization of skilled maternity care: evidence from rural Nigeria

“…This indicates that female education is a strong predisposing factor for utilization of maternal health services in the study area (Andersen & Newman, 2005). The finding on education corroborates several past studies in Nigeria and other countries and reinforces the fact that post-primary education for women is key to improving individual-level and population health indicators and achieving development goals (Desai & Alva, 1998;Ahmed et al, 2010;Smith-Greenaway, 2013;Ononokpono, 2015;UNDP 2018;Ndugga et al, 2020). Indeed, even primary education is far better than none in predicting better child health, and maternal health care utilization, as shown in this study (Smith-Greenaway, 2013;Kifle et al, 2017).…”