Utilization of postnatal services among postpartum mothers at Kawempe national referral hospital, Uganda. A study of attendance patterns at 24 hours, 6 days and 6 Weeks post partum

Abstract

Introduction: The postnatal care (PNC) is care given to the mother and her newborn baby immediately after birth and for the first 42 days of life. This allows women to discuss with their providers healthy behaviors such as exclusive breastfeeding, proper nutrition and the use of family planning, all of which are critical to maternal and child survival. PNC is incredibly important as it ensures that a mother recovers properly from labor and delivery. In Uganda, the level of utilization of PNC remains low and reduces significantly with time. This study aimed to determine the level and factors associated with utilisation of postnatal services among postpartum mothers.

Methods: This was a single cohort study collecting quantitative data from high risk postpartum mothers discharged from Kawempe National Referral Hospital. A total of 404 mothers were selected by simple random sampling technique and the data collected was analyzed using STATA 15. Ethical approval was sought from Makerere University School of Medicine Research and Ethics Committee. An informed consent was obtained from participants and participation was voluntary. Dissemination of the research findings was done through peer review publication of findings and presentations to Makerere University College of Health Sciences.

Results: The average age of the respondents was 26.94 (±5.59) years with an age range of 15-45 years. Majority were married (87.1%, n=352) and were self-employed (78.5%, n=317). A total of 109 (27.0%) mothers had attendance of at least one PNC session, 102 (25.2%) had attended PNC at 6 days while 11 (2.7%) mothers had attended PNC at 6 weeks. Only 9 (2.2%) attended PNC at both 6 days and 6 weeks, while only two mothers were able to come back on the 6th week PNC after missing the 6th day PNC. The utilization of PNC was found to be significantly associated with a reduced transport cost (aOR=1.802, P-Value 0.044) and short distance (aOR=1.845, 95% CI 1.119 - 3.039, P-Value 0.016) to and from the hospital and awareness of at least one danger sign of the postnatal period (aOR=2.443, P-value 0.031).

Conclusion: PNC services at Kawempe National Referral Hospital were found to be poorly utilized as only 3 out of 10 mothers attend subsequent PNC visits following discharge from the hospital. Attendance of PNC was found to be facilitated by improved accessibility of health facilities and awareness of at least one danger sign of the postnatal period. The study recommends awareness campaigns to enhance PNC Knowledge and utilisation among mothers.