Determinants of postnatal care utilization among mothers in Mangochi District, Malawi
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ABSTRACT Postnatal care services, as it is the case with antenatal care, labour and delivery care services, is a fundamental element of the continuum of Essential Obstetric Care (EOC) that can help in decreasing maternal and neonatal morbidity and mortality in low and middle income countries. A community based cross-sectional study, with an objective of exploring the determinants of postnatal care utilization among mothers in Mangochi district, Malawi, was conducted in nine randomly selected villages. A total of 600 randomly selected mothers who gave birth in the past two years preceding data collection, with a child more than six weeks old, were selected using multistage sampling technique. A questionnaire using interviewing method was used to collect the data and the analysis was made using frequency distribution, Chi-square statistic and logistic regression. The level of significance was established at 95% Confidence Level. In the results, almost 85% of the mothers utilized postnatal care services at least once within the postnatal period. The factors that were found to predict postnatal care service utilization were education level of the mother (AOR= 2.42, CI: 1.97,6.04) and that of the partner (AOR=1.5, CI: 1.25,2.49), occupation status of the partner (AOR= 3.2, CI: 1.25,8.01), household level of income (AOR=14.4, CI: 5.90,35.16), decision making (AOR=2.27, CI: 1.13,4.57) , knowledge of available PNC services (AOR=4.2, CI: 2.22,7.41), knowledge of at least one postpartum danger signs (AOR=4.0, CI:2.07,7.50), and place of delivery (AOR=6.9, CI: 3.35,14.14). In conclusion, the determinants for postnatal care utilization in Mangochi district are education level of the mother and that of the partner, occupation status of the partner, household level of income, decision making, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore the study recommends the enhanced strengthening of the provision of Information Education and Communication (IEC) on availability of postnatal care services and possible postpartum danger signs. Programs targeting reinforcement of Maternal and Child Health should emphasise on the need for the mothers to be having hospital delivery. Furthermore, programs should direct efforts towards reaching women who do not avail themselves of postnatal care as identified in the study, and also to reinforce factors that have shown to improve postnatal care uptake among mothers.