Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Abstract

Background Globally, about 289,000 maternal deaths are registered annually. Timely access to quality maternal health services is an effective intervention to reduce maternal deaths. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone. Methods We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7,326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25. Results Out of 7,326 women, 3,329 (45.5%, 95% CI: 44.6–46.8) had their babies have at least a PNC contact, 6,646 (90.7%, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 3,133 (42.8%, 95% CI: 41.9–44.1) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 1.79, 95% CI: 1.20–2.67), having a visit by a health field worker (aOR 1.77, 95% CI: 1.47–2.13), having had eight or more ANC contacts (aOR 1.79, 95% CI: 1.45–2.22), initiating ANC after first trimester (aOR 1.18, 95% CI: 1.04–1.35), being a Muslim (aOR 1.34, 95% CI: 1.11–1.61), belonging to richer wealth quintile (aOR 1.69, 95% CI: 1.22–2.35), being of low parity (2–4) (aOR 1.20, 95% CI: 1.04–1.39), having no big problems seeking permission to access healthcare (aOR 1.52, 95% CI: 1.27–1.83) and having had delivery at home (aOR 1.75, 95% CI: 1.32–2.32) were associated with more PNC utilisation odds. On the other hand, being resident in the Eastern region (aOR 0.31, 95% CI: 0.21–0.46) and urban areas (aOR 0.71, 95% CI: 0.52–0.98) were associated with lower odds of utilising PNC. Conclusion Although maternal PNC utilisation is high, utilisation of PNC by neonates alone and by both the mother and neonatal is low. More focus is needed to mothers and their neonates from the Eastern region, urban areas, Christians, less empowered in terms of healthcare seeking decision making and those who are more parous, utilise less ANC contacts and utilise health facilities for delivery.

Factors influencing utilization of early postnatal care services among postpartum women in Yirgalem town, Sidama Regional State, Ethiopia

“…It encompasses promotion of the health and provision of advices regarding contraception use, immunization, breastfeeding, and nutrition services. 3,4 The first postpartum week is a critical phase in the lives of mothers and their babies since many maternal and neonatal deaths occur in this period due to delay in early identification of the complications. 2 Globally, a large proportions of women die in each year due to pregnancy and childbirth-related complications, 3 and majority of these deaths occur during the postpartum period, particularly in the first week after delivery.…”

“…2 Globally, a large proportions of women die in each year due to pregnancy and childbirth-related complications, 3 and majority of these deaths occur during the postpartum period, particularly in the first week after delivery. 4 The majority (94%) of all maternal deaths occur in low-and lower middleincome countries due to lack of using existing services on timely manner. 5,6 Providing of a postnatal care services at right time could results in reduced maternal and neonatal morbidity and mortality.…”

“…It encompasses promotion of the health and provision of advices regarding contraception use, immunization, breastfeeding, and nutrition services. 3,4 The first postpartum week is a critical phase in the lives of mothers and their babies since many maternal and neonatal deaths occur in this period due to delay in early identification of the complications. 2…”

Evaluating continuum of maternal and newborn healthcare in Rwanda: evidence from the 2019–2020 Rwanda demographic health survey

“…We used the complex sample package of SPSS (version 25.0) statistical software which accounted for the multistage cluster study design [35]. Individual sample weight, sample strata In order to ensure representativeness of the survey results at the national and regional level and to minimize the effects of unequal probability sampling in different strata, data were weighted [12]. Initially, we did descriptive statistics.…”

“…As much as they sound ambitious, they reaffirmed the global prioritization of maternal child health (MCH). However, achieving this will need a high universal coverage of the components of maternal and newborn care for early detection of complications to enable timely intervention [10][11][12]. Therefore, a clear understanding of the utilization behavior of the components of maternal and newborn continuum of care is vital not only towards reducing inequity in health but also towards designing and implementing better strategies aimed at improving the unacceptably poor MCH indicators [13].…”