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.

Postnatal care utilisation among women in rural Ghana: analysis of 2014 Ghana demographic and health survey

“…Finally, in agreement with a previous study [ 34 ], the present study revealed that women who viewed distance to health facility as unproblematic were more likely to utilise PNC as compared to those that perceived it as problematic. Malawi based study also indicated that women who perceived that distance to health facility was not a hindrance to their access to health care were more likely to attend early postnatal care than those who perceived distance to the facility as a problem [ 37 ].…”

“…We observed that women who were working were more probable to utilise PNC as compared to those not working. The results are in line with a Uganda based study by Ndugga, Namiyonga and Sebuwufu [ 34 ] who realised that unemployed women had lower odds of attending postnatal care compared with women who were working. Our results are also congruent with Malawian based study which noted that mothers who were working were 44% more likely to be checked by a professional health worker within 42 days of delivery than women who were jobless [ 28 ].…”

Postnatal care coverage and its determinants in Sri Lanka: analysis of the 2016 demographic and health survey

“…Not only are the visits, the content of care received during ANC detected as important [ 39 ]. Even though some studies elicited a positive association between, receiving recommended number of antenatal clinic visits and PNC, we were unable to elicit it here [ 6 , 36 , 38 , 39 ]. Similarly, several studies found that content of care received and components of ANC were associated with PNC attendance [ 40 ].…”

“…Receiving antenatal care showed positive association with receiving PNC in several other studies. Uptake of recommended number of ANC visits was a factor which increases PNC [ 6 , 36 , 38 , 39 ]. A timely first ANC visit and receiving the adequate number of tetanus injections showed association with PNC as detected by Khaki [ 36 ].…”

“…Receiving a PN check ranged from 26 to 94% in SSA countries [ 5 ]. Only half of Ugandan postpartum women attended PNC services within 2 days of childbirth [ 6 ]. In Myanmar, only around a quarter has received PNC, 4 checkups in postpartum period [ 7 ].…”