The quality of postnatal care services provided at health centres in Ngora District, Uganda: a cross sectional study

Abstract

Introduction: Postnatal care refers to the assistance given to a mother and the baby for a period of up to six weeks from the time of delivery. It involves a four-scheduled personalised care given to a woman immediately after child birth, within 48 hours, two weeks and six weeks (WHO, 2008). Up-take of postnatal care for mothers and their babies is still very low in most developing countries. According to results from Uganda Demographic and Health Survey (UDHS) 2016, 33% of women received postnatal care for their last birth within the critical first two days after delivery. More than two thirds of women (64%) did not receive any postnatal care. For newborn care, 11% of the newborns were taken for their first postnatal check-up within the critical first two days after birth. These studies have shown low utilization of postnatal care services in Uganda. However, little is known about the quality of postnatal care services that is provided to mothers and newborn babies at health facilities in Uganda. Objectives: The study was intended to assess the availability of infrastructure for provision of quality postnatal care at health facilities in Ngora District; to assess quality of the process of postnatal care at health facilities in Ngora District; and to determine the perceptions and satisfaction of mothers with postnatal care services being provided to them at the health facility. Methods: This study was conducted through a descriptive cross-sectional study of quality of postnatal care services provided to mothers and their babies in Ngora District. Observation guide and checklist was used to collect data on structure and process for quality of postnatal care. Interviewer administered questionnaire was used to collect data from 344 Mothers and sixteen midwives were observed while providing postnatal care. Data was analysed using STATA vision 12 and presented inform of percentage scores for quality of postnatal care. Results: The quality of postnatal care offered to mothers and newborn babies was found to be below standard. The overall mean score for quality of postnatal care provided in Ngora district was found to be at 52.1%. Monitoring and examination of mothers and their newborn babies after delivery was not routinely done according to set standards. Ngora HC IV scored 66.0% while Agu HC III scored only 32.4%. Assessment of re-visit mothers and babies was poor with all the health facilities scoring below 50%. The highest score was by Ajeluk HC III with 49.2%. However, 58.1% of mothers were satisfied with postnatal care services being provided to them at health facilities, 29.4% were fairly satisfied and only 5.8% were not satisfied with the services. Conclusion: The quality of PNC services provided in Ngora was below standard. There was lack of infrastructure, equipment and supplies for provision of postnatal care according to the required standard. However, mothers who are the beneficiaries of PNC services perceived it as satisfactory. Recommendation: To improve the quality of PNC in Ngora District; there is need to provide infrastructure, procure essential equipment and supplies and regularly conduct support supervision to health facilities.