Multilevel mixed effect analysis of adequate postnatal care in Ethiopia: Evidence from EMDHS, 2019

Abstract

Background The postpartum period is critical for both the mother's and newborn child's health and survival. Rising morbidity and mortality are usually the consequence of absence of adequate, suitable, or timely care during that time period. There is lack of information on the adequacy of postnatal care in Ethiopia and this study was aimed to investigate adequacy of postnatal care and its determinants in the study area. Methods In this study we used a cross-sectional dataset from the Ethiopia Mini Demographic and Health Surveys conducted in 2019. A multistage stratified clustered design applied and survey weights were used to take into account the complicated sample design. A multilevel mixed effects logistic regression was fitted on 3772 women who were nested within 305 clusters. The fixed effect models were fitted and expressed as adjusted odds ratios with 95% confidence intervals, while intra-class correlation coefficients, median odds ratio, and proportional change in variance explained measures of variation. As model fitness criteria, the deviance information criterion and the Akaike information criterion were used. Results This study found that only 563(16.14%, 95% CI: 16.05–16.24) women had adequate post natal care. Age of between 25–35 years old (AOR = 1.55, 95%CI = 1.04–2.31), secondary level of education (AOR = 2.23, 95%CI = 1.43–3.45), Having parity of between two and four had (AOR = 0.62, 95%CI = 0.42 0.93), having ANC follow up four and above (AOR = 1.74, 95%CI = 1.31–2.33), being residents of Oromia region (AOR = 0.10, 95CI = 0.02–0.43) were strong predictors of adequate postnatal care. () Conclusion The study found that prevalence of adequate PNC in Ethiopia was significantly low. To increase postnatal care adequacy, it was recommended to reinforce existing policies and strategies such as increasing number of antenatal care follow up, and scheduling mothers based on the national postnatal care follow-up protocol.