Factors associated with postnatal care utilization among postpartum women in Ethiopia: a multi-level analysis of the 2016 Ethiopia demographic and health survey

Abstract

Background: Most postpartum women and newborns do not utilize postnatal care due to less emphasis given especially in developing countries. Understanding individual and community-level factors associated with postnatal care will help to design appropriate strategies and policies for improving service utilization. Therefore, this study aimed to assess individual and community-level factors associated with postnatal care utilization in Ethiopia.Method: This study used the Ethiopian Demographic and Health Survey (EDHS) data of 2016. A total of 4489 women who gave birth 2 years before the survey were included. Two-stage stratified cluster sampling technique was used. The analysis was done using Stata version 14.0 after checking for basic assumptions of multilevel logistic regression. Multilevel mixed-effects logistic regression was used to identify determinants of postnatal care utilization. An adjusted odds ratio with a 95% confidence interval was used to show the strength and direction of the association. Results: Husband with secondary education [AOR = 0.17, 95% CI = (0.04, 0.68)], four or more antenatal care visit [AOR = 10.77, 95% CI = (2.65, 43.70)], middle wealth quintile [AOR = 3.10, 95% CI = (1.12, 8.58)] were individual level factors. Community level education [AOR = 2.53, 95% CI = (1.06, 6.06)] and community level of health service utilization [AOR = 2.32, 95% CI = (1.14, 4.73)] were the predictors at community level.Conclusion: Wealth index, number of antenatal care visits, husband education, community level of education and health service utilization were significantly associated with PNC service utilization. Provision of quality antenatal care, improvement of the educational status of women and husband involvement in PNC are important strategies to increase PNC service utilization.

Postnatal Care Utilization Coverage and its Associated Factors Among Mothers in South Gondar Zone, Northwest Ethiopia: A Cross-Sectional Study

“…When compared to women who gave birth at home, those who gave birth at a health facility were more likely to use PNC services. The finding is similar to studies conducted in Ugandan ( Ndugga et al., 2020 ), Halaba Kulito town, Southern Ethiopia ( Abebo & Tesfaye, 2018 ), Ethiopia ( Adane et al, 2020 ; Ayele et al, 2019 ), and Bangladesh ( Adane et al, 2020b ). This could be due to women who give birth in a health facility have a better chance of being informed, and educated about the different types, benefits, and options for PNC services, as well as the danger signals of postpartum depression.…”

“…Rural women were less likely to use the PNC service than urban women. This finding is supported by the studies conducted in Zimbabwe and Ethiopia ( Adane et al, 2020 ; Muchabaiwa et al, 2012 ), and Swaziland and Uganda ( Ndugga et al, 2020 ; Tsawe et al, 2015 ). The reason for this could be that urban women have better education, access to health care, and are more aware of the importance of PNC service utilization ( Fenta et al., 2021 ).…”

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

“…However, the results of the correlation test also showed insignificant results between the two variables (p = 0.128). These findings differ from previous studies which inform that socioeconomic or wealth status is associated with postnatal care 8,14 . 5 shows the cross-tabulation between the percentage of health centers with sufficient midwives and 1 st neonatal visit in Indonesia.…”

Magnitude of antenatal care service uptake and associated factors among pregnant women: analysis of the 2016 Ethiopia Demographic and Health Survey

“…The Open access justification could be that educated women took more ANC because they had more awareness about regular ANC uptake benefits such as reduced risks of pregnancy and safe childbirth. Educated husbands may have better communication with their wives and be able to explore the importance of ANC uptake and other maternal health services 36 which could in turn provide their wives with more freedom. 37 The uptake of ANC services among married women was higher compared with women living alone.…”