Postnatal care attendance and associated factors among mothers accessing child vaccination services at Kawempe National Referral Hospital in Uganda

Abstract

Introduction: In Uganda, there’s sub-optimal uptake of postnatal care services (PNC) in the continuum of maternal care hence, making it a poorly attended service in efforts to achieve safe motherhood. According to the 2016 DHS, only 54% of women aged 15-49 and 56% of newborns receive a postnatal check within two days of delivery. This study assessed the level of postnatal care service attendance and associated factors among mothers accessing vaccination services for their children in Kawempe National Referral Hospital.

Methods: A descriptive hospital based cross sectional study was conducted. The study population was 378 postpartum mothers accessing vaccination services for their children at nine months. The data were collected using pre-tested interviewer administered questionnaires. Data analysis was done using SPSS version 20 of which univariate, bivariate and multivariate statistical tests were employed. Logistic regression was used to determine the factors associated with attendance of postnatal care services. Variables with a p-value <0.2 at bivariate analysis and/or those that were biologically plausible were considered for multivariable analysis. Statistical significance was established at a p-value of <0.05 on multivariable analysis.

Results: A total of 378 mothers participated in the study. The average age was 26.7 year. Less than half of the respondents 169 (44.7%) reported to have attended all the scheduled PNC visits. Postnatal care attendance was found to reduce with time with 92.3% attendance at 24 hours, 61.4% attendance at 6 days and 44.7% attendance at 42 days. Only 18 (4.8%) mothers reported that they did not attend any postnatal care session. At multivariable analysis, attendance of PNC was found to be significantly associated with mothers staying close to KNRH (aOR=1.826, P-0.011) and mothers who had attended ANC (aOR=3.183, P-0.016).

Conclusion: This study revealed that PNC at KNRH were poorly attended as only 4 out of 10 mothers attended all PNC visits while less than 1 in 10 mothers did not attend PNC, which was lower than the national average where 3 in 10 mothers that did not attend PNC. Accessibility to PNC served as the major barrier to PNC attendance. To increase access to PNC, clinic-level facilities, and health centers, that currently do not provide PNC should be supported to provide quality PNC to women and newborns since they are more accessible to PNC clients than hospitals. Policymakers (MOH) should promote ANC attendance by developing and supporting the implementation of the national communication plan for ANC.