Determinants of postnatal care non-utilization among women in Demba Gofa rural district, southern Ethiopia: a community-based unmatched case-control study

Abstract

Background Maternal and neonatal mortality remain a significant problem across much of the developing world, especially in sub-Saharan Africa countries. In Ethiopia, most maternal and neonatal deaths occur during the postpartum period; this is a critical time for monitoring the health of women and newborns, but the most neglected period for care. In rural communities of Ethiopia, the utilization of postnatal care service is very low and evidence on which factors contribute to the non-utilization of postnatal care (PNC) is insufficient. Consequently, this study was designed to identify the determinants of postnatal service non-utilization among women who gave birth in Demba Gofa rural district, Southern Ethiopia. Methods A community-based unmatched case-control study was conducted among 186 cases (postnatal care non-utilizers) and 186 controls (postnatal care utilizers) in Demba Gofa rural district from March 1 to April 10, 2019. A previously tested interviewer-administered structured questionnaire was used for data collection. Binary logistic regression analysis was performed. In the final multivariable logistic regression analysis model, a p-value of less than 0.05 and an Adjusted Odd Ratio (AOR) with a 95% confidence interval (CI) was used to determine variables for postnatal care non-utilization. Results In this study, women who delivered recently were incorporated within 186 cases and 186 controls. Not knowing the availability of PNC services (AOR: 4.33, 95% CI: 1.71–10.99), having a home delivery (AOR: 7.06, 95% CI: 3.71–13.44), ANC non-attendance (AOR: 6.14, 95% CI: 3.01–12.50), unable to make an independent decision (AOR: 9.31, 95% CI: 3.29–26.35), and not participating in the Women’s Development Army (WDA) (AOR: 5.09, 95% CI: 2.73–9.53) comprised the determinants which were assessed for non-utilization of postnatal care services. Conclusions Encouraging institutional delivery along with integrated health education about postnatal care and postnatal danger signs, empowering women to execute independent decisions, accessing PNC services and strengthening participation in the Model Families will likely improve postnatal care service utilization in the district of Ethiopia.

Factors Related to Postnatal Care Utilization in Indonesia in 2018: An Ecological Study

“…The results of the correlation test also showed significant results between the two variables (p=0.040). This finding is in line with the findings in previous studies, which informed that mothers who did ANC visits performed more postnatal care than mothers who did not carry out ANC visits 11,12 . This is because mothers who complete ANC will get counseling from midwives to carry out postnatal care so that mothers who do antenatal care will be more motivated to carry out postnatal care than mothers who do not make ANC visits 7,13 .…”

Effectiveness of checklist-based box system intervention (CBBSI) versus routine care on improving postnatal care utilization in Northwest Ethiopia: a cluster randomized controlled trial

“…The result of this study showed that mother’s place of delivery had contributed for attending three PNC visits, this finding goes in line with a comparative report from developing countries that showed low proportion of mothers who delivered at home went for postnatal visits [ 6 , 33 ]. In Ethiopia, mothers are encouraged to deliver at health center and hospitals, where they can get skilled care at the intrapartum and postpartum periods.…”

Women Empowerment and Utilization of Maternal Health Care in Pakistan

“…Our dependent variable (PNC) for our third model will be measured as; a mother who left the delivery facility within 24 hours is considered as a non-utilizer of Postnatal Care and hence denoted by '0'. If she did stay at the delivery facility for more than 24 hours, she would be treated as a utilizer of postnatal care and denoted by '1' in our binary definition (Manote & Gebremedhin, 2020). We have used this measure to avoid the information loss we faced during the construction of the above-mentioned variable.…”