Non-utilization of postnatal care and its associated factors among women who gave birth in rural districts of Northern Ethiopia: A community-based mixed-method study

Abstract

Objectives: This study assessed the non-utilization of PNC services, identified factors associated with PNC non-utilization, and explored barriers to PNC utilization in the rural community. Method: A community-based mixed-cross-sectional study was conducted from 20 March to 20 April 2020 among 521 women who gave birth in the last 12 months prior to this survey. A multistage sampling and face-to-face interview techniques were used for the quantitative data collection, and a purposive sampling technique was used to select the study participants. In-depth interviews were used for the qualitative data collection. The quantitative data were entered into EpiData version 3.1 and then exported to SPSS version 25 for analysis. A binary logistic regression analysis was used to test the association between the independent and outcome variables. A p-value of <0.2 was used as the cutoff value to include variables in the multivariate analysis. Finally, a p-value of <0.05 was used to declare an independent association. The qualitative data were manually sorted, cleaned up, and labeled as themes. Every major theme was identified and enumerated, and the meaning units were cited together with the relevant participant’s socio-demographic details. Result: The non-utilization of postnatal care was found to be 75.4% in the area. Normal delivery, fewer than four antenatal care visits, inaccessibility to transportation, and poor knowledge of postnatal care were all identified as factors enhancing non-utilization of postnatal care. However, being informed about postnatal care positively influences postnatal care utilization. Poor awareness, information gaps, cultural and religious beliefs, service inaccessibility, and the unfriendly approach of healthcare workers were all explored as barriers in the qualitative study. Conclusions: The non-utilization of PNC services in this study was higher than the majority, but not all, of the previous comparable local and worldwide findings. Mode of delivery, hearing postnatal care information, the number of antenatal visits, transportation availability, and knowledge of postnatal care services were factors affecting the non-utilization of postnatal care. The clients’ poor awareness, information gaps, cultural and religious beliefs, service inaccessibility, and healthcare staff’s inauspicious approach were barriers explored. Therefore, counseling and transportation access need to be reinforced in the setting.

Antenatal care component utilization and associated factors among pregnant women in Ethiopia: Multilevel analysis of Ethiopian Mini Demographic and Health survey 2019

“…Existing evidence shows that Antenatal Care (ANC) is an appropriate gateway for the full package of maternal health care services [ 6 ] and those with good adherence to ANC visits are more likely to stick to the remaining services in the continuum of maternal health care services compared to those with poor compliance [ 7 , 8 ]. On the other hand, ANC visits should be accompanied by provision and utilization of the essential components which are said to be the building blocks of the care in ensuring its quality [ 9 ].…”

Factors associated with utilization of physical therapy services during pregnancy and after childbirth

“…Four previous studies have identified the factors affecting utilization or non-utilization of maternal healthcare services and these studies were conducted in China [ 19 ], Ethiopia [ 20 , 21 ], and India [ 22 ]. Factors associated with the use of maternal health services included travel distance to the hospital and women's perception, choice, autonomy, and characteristics (e.g.…”

“…source of referral, pain and disability) [ 23 ], it remains unknown whether disparities exist in terms of factors associated with physical therapy utilization versus overall medical utilization in pregnant and postpartum women due to the lack of direct access to physical therapy in some countries or locations (i.e. Taiwan) [ 24 ] and socio-cultural differences among countries [ 21 ]. While evidence supports physical therapy as a safe and effective treatment option for women at various life stage [ 25 ], to date, no studies have compared the characteristics of women who utilized and did not utilize physical therapy during pregnancy and/or after childbirth in Taiwan.…”

Post-natal care: a vital chance to save mothers and infants! Exploring barriers and factors associated with it: a mixed study

“…Postnatal care obstacles and other factors have been found in prior work. Findings from studies conducted in Jabitena district, Amhara regional state, Northwest Ethiopia, Northern Ethiopia, and Wolkite, Ethiopia, as well as rural areas of Northern Ethiopia, Tigray, Ethiopia, Debre Tabor town, Northern Ethiopia, Hawassa Zuria, Northern Ethiopia at Adigirat town, Addis Ababa, in Sodo Zuria and Shebe Sombo Woreda, Jimma, revealed that the prevalence of postnatal service utilization ranges from 20.2% to 77.7% (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

“…The number of children ever delivered, the mother's level of literacy, and radio listening frequencies were determined to be the drivers of PNC use in a study conducted in parts of Ethiopia. Other factors such as more than four pregnancies, wanted pregnancy, spontaneous vertex delivery, husband with secondary education, delivery with cesarean section, secondary education or above for the mother, a monthly household income of more than 1,500 ETB, planned and supported prior pregnancy, institutional delivery of last pregnancy, accessing health care, having a positive attitude towards the use of postnatal services, and having a living child born from the previous pregnancy show significant associations with postnatal service utilization (13,14,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29).…”