Determinants of postnatal care utilization in Tigray, Northern Ethiopia: A community based cross-sectional study

Berhe, Almaz; Bayray, Alemayehu; Berhe, Yibrah; Teklu, Alula M.; Desta, Amanuel; Araya, Tsige; Zielinski, Ruth; Roosevelt, Lee

doi:10.1371/journal.pone.0221161

Cited by 53 publications

(71 citation statements)

References 14 publications

(21 reference statements)

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“…The current analysis shows that mothers from rural areas are less likely to receive FPNC compared to mothers in urban areas. This is similar to what was reported in other studies in Ethiopia 32,36 The other factor which detected strong positive association in several studies around the globe was the institutional delivery 6,25,31,44 . We could not demonstrate that association due to the fact that more than 99% deliveries occurred in institutions.…”

Section: Background Characteristicssupporting

confidence: 91%

Postnatal Care Coverage and its Determinants in Sri Lanka : Analysis of the 2016 Demographic and Health Survey

Perera

Amilani

Assefa

2020

Preprint

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Background: Postnatal care (PNC) is important for preventing morbidity and mortality in mothers and newborns. Even though its importance is highlighted, PNC received less attention than antenatal care. This study determines the level of PNC coverage and its determinants in Srilanka. Methods: This is a secondary analysis of the 2016 Demographic and Health Survey. Receiving full postnatal care (FPNC) was defined with a set of indicators to detect adequate care for mother and newborn. Demographic and socio-economic associated factors for receiving FPNC were identified using binary and multiple logistic regression. Variables that had marginal relationship with receiving FPNC which p-value less than or equal to 0.2 at binary analysis were selected and included in the multiple logistic regression models. We used manual backward stepwise regression to identify variables which had independent association with receiving FPNC on the basis of adjusted odds ratios (AOR), with 95% confidence interval (CI) and p-value less than 0.05. All analyses were performed in SPSS 25. Results: Of the 8813 women with a live birth in the last five years, more than 98% had timely institutional care from skilled staff. More than three-fourth of mothers (n=5104) received the FPNC according to WHO guideline. Four factors were positively associated with receiving FPNC: mothers received antenatal home visits by Public health midwife (AOR=1.98, 95% CI 1.65-2.39), mothers who got information about antenatal complications and places to go at antenatal clinics (AOR=1.56, 95% CI 1.27 -1.92), been Sinhala (AOR= 1.89, 95% CI 1.35-2.66) and having own mobile phone (AOR=1.19, 95% CI 1.02 -1.38). Mothers who are residing in rural area (AOR=0.697 95% CI = 0.52 – 0.93] compared to those who reside in urban areas and maternal age between 20 and 34 years [AOR= 0.72, 95% CI 0.54 – 0.97] compared to maternal age less than 20 years were detected as negatively associated. Conclusion: Receiving FPNC in Srilanka is found to be higher than other countries in the region. However, inequity remains to be a challenge. Few socio-demographic factors are associated with FPNC coverage. Strategies that aim to improve postnatal care should target improvement of social determinates of health.

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Section: Background Characteristicssupporting

confidence: 91%

Postnatal Care Coverage and its Determinants in Sri Lanka : Analysis of the 2016 Demographic and Health Survey

Perera

Amilani

Assefa

2020

Preprint

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“…Mothers likely received PNC before discharge, would be delivered by cesarean section. Previous studies in rural Ethiopia [12][13][14] also showed women who had cesarean births used more postpartum care than those who had vaginal births. The result of this study revealed that the use of PNC services has been significantly influenced by knowledge of antepartum, intrapartum, or postpartum danger signs This is in line with the studies carried out in Ethiopia [13,14].…”

Section: Discussionmentioning

confidence: 95%

“…Previous studies in rural Ethiopia [12][13][14] also showed women who had cesarean births used more postpartum care than those who had vaginal births. The result of this study revealed that the use of PNC services has been significantly influenced by knowledge of antepartum, intrapartum, or postpartum danger signs This is in line with the studies carried out in Ethiopia [13,14]. An integrative review by Adams and Smith suggested that awareness about pregnancy, childbirth, and/or postpartum complications is one of the common determinants of postpartum care use in developing countries [27].…”

Section: Discussionmentioning

confidence: 95%

Determinants of postnatal care utilization in Ethiopia: a multilevel analysis

Tiruneh¹,

Worku

Berhane

et al. 2020

BMC Pregnancy Childbirth

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Background The expansion of primary health care services in Ethiopia made basic health services available and accessible. The Last Ten Kilometers (L10K) project has strengthened the primary health care system through implementing innovative strategies to engage local communities to improve maternal and newborn health care behavior and practices in Amhara, Oromia, Southern Nations, Nationalities and Peoples [SNNP], and Tigray regions over a decade. Despite the efforts of the government and its partners to improve the use of maternal health services, the coverage of postnatal care is persistently low in the country. This study examined the individual and community level determinants for the persistently low uptake of postnatal care in the project areas. Methods The study used a cross-sectional population-based survey that measured maternal and newborn health care practices among women who had live births in the last 12 months preceding the survey in Amhara, Oromia, SNNP, and Tigray regions. Multilevel random effects binary logistic regression analysis was used to assess the independent effects of community-and individual-level factors and moderating effects on the uptake of postnatal care. Results This study identified region of residence, obstetric factors, and health service-related factors to be significant determinants for use of postnatal care. Obstetric factors include knowledge of obstetric danger signs (AOR: 1.30; 95% CI: 1.05–1.60), cesarean section mode of delivery (AOR: 1.96; 95% CI: 1.28–3.00), and institutional delivery (AOR: 10.29; 95% CI: 7.57–13.98). While the health service-related factors include attended family conversation during pregnancy (AOR: 1.48; 95% CI: 1.04–2.12), birth notification (AOR: 2.66; 95% CI: 2.15–3.29), home visits by community health workers (AOR: 1.98; 95% CI: 1.58–2.50), and being recognized as a model family (AOR: 1.27; 95% CI: 1.03–1.57). Conclusion This study demonstrated that community-level interactions and promotive health services including antepartum home visits by community health workers, family conversation, birth notification, and model family, are important determinants to seek postnatal care. The findings also highlight the need for expansion of health facilities or design appropriate strategies to reach the disadvantaged communities. Program managers are recommended to strengthen community-based interventions to improve postnatal care utilization.

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“…There have been some studies that examined why PNC service utilisation remains low in Ethiopia. Some of these studies had a small sample size [ 15 , 16 ] and others covered a very small geographical area [ 17 , 18 ] that may put the representativeness of the studies and generalisability of the findings into question. Although there have been four rounds of the EDHS, studies that used these data have concentrated on the 2016 survey [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Postnatal Care Service Utilisation in Ethiopia: Reflecting on 20 Years of Demographic and Health Survey Data

Mekonnen

Dune

Perz

et al. 2020

IJERPH

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Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban–rural variations of PNC service utilisation. Methods: This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation. Results: Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6–6.9%) in 2000 to 18.5% (95% CI: 16.4–20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6–30.7%) in 2000 to 47% (95% CI: 60.4–67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women. Conclusions: The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopia.

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Determinants of postnatal care utilization in Tigray, Northern Ethiopia: A community based cross-sectional study

Cited by 53 publications

References 14 publications

Postnatal Care Coverage and its Determinants in Sri Lanka : Analysis of the 2016 Demographic and Health Survey

Postnatal Care Coverage and its Determinants in Sri Lanka : Analysis of the 2016 Demographic and Health Survey

Determinants of postnatal care utilization in Ethiopia: a multilevel analysis

Postnatal Care Service Utilisation in Ethiopia: Reflecting on 20 Years of Demographic and Health Survey Data

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