Early postnatal care use by postpartum mothers in Mundri East County, South Sudan

Abstract

BackgroundGlobally, most maternal and newborn deaths are within the first week of delivery. Early postnatal-care (EPNC) visits between 2 and 7 days detects early morbidity and averts deaths. However, there is scarcity of information on use of EPNC in Mundri East County, South Sudan. This study investigated factors associated with EPNC use among postpartum mothers in Mundri East County, South Sudan.MethodsThis was an analytical cross-sectional study of 385 postpartum mothers from 13 health facilities. Data was collected by structured questionnaires, entered in EpiData and analyzed with STATA at 5% significance level. Chi-squared, Fisher’s exact and Student’s t-tests were used for bivariate analysis and logistic regression for multivariable analysis.ResultsThe mean age of respondents was 27.9-years (standard deviation: 6.7), 276 (71.7%) were below 30-years, 163 (42.3%) were Muru ethnicity, 340 (88.3%) were single and 331 (86.1%) were unemployed. 44 (11.4%; 95% CI: 8.4–15.0) used EPNC. Poor health services access at government health facilities (Adjusted odds ratio (AOR) = 0.18; 95% CI: 0.05–0.61; P = 0.006), more than 1-h access to health facility (AOR = 0.27; 95% CI: 0.09–0.78; P = 0.015), at least secondary maternal education (AOR = 5.73; 95% CI: 1.14–28.74; P = 0.034) and receipt of PNC health education post-delivery (AOR = 3.47; 95% CI: 1.06–11.33; P = 0.004) were associated with EPNC use.ConclusionsUse of EPNC in Mundri East County, South Sudan was low. It was significantly reduced at government and inaccessible health facilities. However, it increased with receipt of PNC health education after delivery and at least secondary level of education.

Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey

“…Likewise, our finding that distance to a health facility is not a problem in accessing health care was a statistically significant correlate of EPNC has also been reported elsewhere in sub-Saharan Africa [41,55]. Long distances limit the willingness and ability of postpartum women to seek postnatal care due to the physical difficulties of travel and high costs of motorized transport [18]. In addition, multiple demands including caring for the newborn and older children often prohibit women from seeking postnatal care where proximity to a health facility is perceived to be a challenge.…”

“…Maternal mortality remains a challenge in achieving the Sustainable Development Goal target of reducing the global maternal mortality ratio to fewer than 70 maternal deaths per 100,000 live births in low-resource settings like Uganda. Prior studies have noted the importance of early postnatal checkups in improving maternal survival [18,19,46,47]. This study investigated the determinants of early postnatal care attendance (receipt of postnatal care within 2 days after childbirth) among women in Uganda based on data from the 2016 UDHS.…”

“…Andersen's Behavioral Model of health service utilization provided a relevant framework for understanding factors that shape use of early postnatal care [24]. This framework proposes that use of health care services, including postnatal care, is a function of three sets of characteristics-predisposing characteristics, such as age, religion, wealth, and marital status [12,18,21,25,26]; enabling characteristics, such as ANC attendance and distance to a health facility [21,27,28] and need characteristics, such as place of delivery, birth order, and size of the baby at birth [12,26].…”

“…A few studies have investigated early postnatal care attendance in developing countries such as Bangladesh [17], Nepal [13], Sudan [18], and Zambia [19]. Most of these studies found that delivery at health facilities, skilled birth attendance, proximity to health facilities, having at least a secondary education, and receiving postnatal health education after delivery were associated with use of EPNC.…”

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

“…Likewise, our finding that distance to a health facility is not a problem in accessing health care was a statistically significant correlate of EPNC has also been reported elsewhere in sub-Saharan Africa (41,50). Long distances limit the willingness and ability of postpartum women to seek postnatal care due to the physical difficulties of travel and high costs of motorized transport (18). In addition, multiple demands including caring for the newborn and older children often prohibit women from seeking postnatal care where proximity to a health facility is perceived to be a challenge.…”