Magnitude and determinants for place of postnatal care utilization among mothers who delivered at home in Ethiopia: a multinomial analysis from the 2016 Ethiopian demographic health survey

Abstract

IntroductionAbove half of mothers in Ethiopia give birth at home. Home based care within the first week after birth as a complementary strategy to facility-based postnatal care service is critical to increase the survival of both mothers and newborns. However, evidence on utilization of postnatal care and location of service among mothers who delivered at home in Ethiopia is insufficiently documented. Therefore, this study assessed the magnitude and determinants for place of postnatal care service utilization among mothers who delivered at home in Ethiopia.MethodsWe used the 2016 Ethiopian Demographic and Health Survey, and extracted data from 4491 mothers who delivered at home during 5 years preceding the survey. A multinomial logistic regression model was applied to examine the determinants of both facility and home -based postnatal care service utilization. Likelihood ratio test was used to see the model fitness and p-value of < 0.05 was used to determine statistical significance at 95% confidence interval.ResultsFrom the total 4491 mothers who delivered at home, only 130(2.9%) and 236(5.3%) of them utilized postnatal service at home and at a health facility respectively. Being from an urban region (AOR = 0.378, 95%CI: 0.193–0.740), ever using the calendar method to delay pregnancy (AOR = 0.528, 95%CI: 0.337–0.826), receiving four and above antenatal care visits (AOR = 0.245, 95%CI: 0.145–0.413) and having a bank account (AOR = 0.479, 95%CI: 0.243–0.943) were the factors associated with utilizing home- based postnatal care. Similarly being a follower of the orthodox religion (AOR = 1.698, 95%CI: 1.137–2.536), being in the rich wealth index (AOR = 0.608, 95%CI: 0.424–0.873), ever using the calendar method to delay pregnancy (AOR = 0.694, 95%CI: 0.499–0.966), wantedness of the pregnancy (AOR = 0.264, 95%CI: 0.352–0.953), receiving four and above antenatal care visits (AOR = 0.264, 95%CI: 0.184–0.380) and listening to radio at least once a week (AOR = 0.652, 95%CI: 0.432–0.984) were the determinants of facility-based postnatal care utilization.ConclusionThe coverage of postnatal care service utilization among mothers who delivered at home was very low. Living in urban region, following the Orthodox religion, having higher wealth index, having a bank account, ever using calendar method to delay pregnancy, wantedness of the pregnancy, receiving four and above antenatal care visit and listening to radio at least weakly were associated with postnatal care service utilization. Therefore, targeted measures to improve socio-economic status, strengthen the continuum of care, and increase health literacy communication are critically important to increase postnatal care service utilization among women who deliver at home in Ethiopia.

Determinants of postnatal checkup for newborns in Ethiopia: Further analysis of 2016 Ethiopia demographic and health survey

“…Lastly, regarding religion, the odds of postnatal checkups for the newborn among Catholic, Protestant, and Muslim were less likely to utilize newborn care than the orthodox follower. This is finding is supported by a study done in Ethiopia [33] in which being a follower of the orthodox religion associated with postnatal care utilization of mothers and newborns. Even if, we could not find other research to justify, the possible explanation could be due to differences in religious advice among followers to utilize the postnatal care service of the newborn.…”

Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

“…In Indonesia, it was noted that most mothers and family members were unaware of the characteristics and duration of the postpartum period [26]. Many authors suggest that the antenatal and predischarge periods are opportunities for health care providers to emphasize the importance of PNC to women and their families [16] [17] [19].…”

Do mothers who delivered at health facilities return to health facilities for postnatal care follow-up? A multilevel analysis of the 2016 Ethiopian Demographic and Health Survey

“…“Returned to health facility for PNC use” was developed with a value of “1 = Yes” if either of the mother or baby or both returned at least once for PNC check at any health facility and “0 = No” if neither the mother nor baby were checked at any health facility within 42 days of post-delivery for the mother and two months for the baby. The reason why we include the PNC use for babies up to two months after birth was explained elsewhere [ 20 ].…”

“…On the other hand, studies on how many mothers are returned to health facilities for PNC use after they delivered at health facilities are rare. Four studies in Ethiopia further analyzed 2016-EDHS data to explore PNC service utilization considering different target populations: among fourth ANC utilizers [ 19 ], among home deliveries [ 20 ], and among home and health facility deliveries [ 21 , 22 ].…”