Utilization of preventive postnatal care services among mothers and associated factors in Dodoma City Council, Tanzania

Abstract

ABSTRACT Background: To be effective, Postnatal care (PNC) should function as routine preventive care during the period of high risk for maternal and newborns ill health. The reasons for low utilization of postnatal care services in Tanzania have not fully been established and few studies have looked into the factors associated with the World Health Organization recommended frequency of PNC checkups. Objective: This study examined utilization of preventive postnatal care services among postnatal mothers and associated factors in Dodoma city council, Tanzania. Materials and Methods: A quantitative facility-based cross-section study was carried out among 419 women who had completed their postnatal period. Questionnaires were used to gather data on participant’s characteristics (socio-demographics and obstetric), utilization of preventive PNC, and enabling, predisposing and need factors associated with utilization. Data were summarized at a univariate level by descriptive statistics; at bivariate level associations were tested by the chi-square test, all variables with a P < 0.2 were entered into a multivariate logistic regression analysis to obtain CORs and 95% CI, followed by computation of AORs to control for confounders. Significance was set at P < 0.05. Results: Close to three quarters (72.5%) used post-natal care services at some point, however, very few (2.6%) made the crucial 1st visit in 48 hours; less than a quarter (21.7%), made the crucial 2nd visit (3rd to 7th day), unexpectedly less than two thirds (62.1%) received the first appointment for postnatal care in the first 24 hours. After controlling for confounders, having positive attitudes that there is a likelihood of postpartum complications (AOR = 2.17, 95% CI:1.00 – 4.69), early booking (1 – 12 weeks of gestation) (AOR = 3.53, 95% CI:1.22 - 10.19) , and receiving health education for post-natal care (AOR = 3.36, 95% CI:1.96 – 5.77) and delivery at a public facility (AOR = 0.35, 95% CI:0.16 – 0.77) were significantly associated with PNC utilization. Conclusion and Recommendation: Though close to three quarters use PNC services at some point, use was very low in the crucial times when the risk of complications and death is very high. Further studies are required to establish reasons for low utilization of PNC services in crucial times.