Factors associated with postnatal care services utilization among mothers who gave birth in the last 12 months, Hoima district

Abstract

BACKGROUND: Maternal mortality ratio is still high in Uganda, 336/100,000 live births and about 75% of the maternal deaths occur during the postnatal period despite efforts in trying to enhance maternal and child health. Proper utilization of Postnatal Care services could reduce mortalities of both the mothers and newborn babies. However, Postnatal Care services utilization is still low in Bunyoro sub region (39%) and factors contributing to low utilization are not well known. OBJECTIVE: To assess the level of postnatal care service utilization and associated factors among women of reproductive age who gave birth in the last 12 months in Hoima district, at six hours, six days and six weeks. METHODS: A cross sectional study using qualitative and quantitative methods of data collection. Multistage and simple random samplings were used in selection of participants for quantitative data and purposive sampling for qualitative data. Data was analyzed from STATA 14.0 and thematic content analysis. RESULTS: The proportion of women who utilized postnatal care services at six hours was 83.65%, at six days 34.06% and 55.04% at six weeks. Mother’s occupation (APR=1.22, 95% CI:1.11-1.34) and place of delivery (APR=0.57, 95%CI: 0.42-0.78) were found to be significant factors associated with Postnatal care services use at six hours. Mothers who delivered from home/TBAs were 0.57 times less likely to use postnatal care services compared to those who delivered from a health facility. At six days, knowledge of Postnatal care services (APR=1.86, 95% CI: 1.08-3.22) Any TBAs (APR= 0.59, 95% CI: 0.43-0.81) and distance to a nearby health facility (APR= 1.75, 95%CI: 1.13-2.72) were associated with Postnatal care use. At six weeks, knowledge of PNC services (APR= 1.66, 95% CI: 1.19-2.33), partner’s occupation (APR= 1.22, 95% CI: 1.01-1.49) and TBA use (APR= 0.55, 95% CI: 0.42-0.72) were significant factors. CONCLUSION: More than half of the respondents had used PNC services at six hours after delivery. Mother’s occupation and place of delivery were found to be significant factors associated with PNC use at this level in Hoima district. There was a significant reduction in PNC utilization at six days, only less than half of the respondents had used PNC services at this level. Factors associated with PNC utilization included knowledge about PNC services, distance to a nearby health facility and any TBAs. At six weeks, about half of the respondents had utilized PNC services in Hoima district. Knowledge about PNC, partner’s occupation and any TBAs were significantly associated with PNC services utilization. Interventions to improve PNC utilization should aim at increasing knowledge about PNC services so that women and their partners understand its importance and dangers of not attending PNC.