Assessment of maternal postnatal care utilization and associated factors among women infants aged 2-6 months in Shinyanga rural district, Shinyanga region

Abstract

Maternal postnatal care (PNC) is an essential intervention towards reduction of maternal mortality. About 61 percent of maternal deaths occur in the postpartum period. Despite its importance, utilisation of maternal PNC has remained low. A descriptive cross-sectional study was conducted to assess utilisation of maternal PNC among women with infants aged 2-6 months in Shinyanga Rural District, Shinyanga Region. The study was carried out in June 2010 and involved a sample of386 women from 36 hamlets of 12 randomly selected villages (three hamlets per village). Face-to-face structured interviews were conducted to collect data on socio-demographic characteristics, elements of PNC provided, method of delivery, mother's awareness of PNC, postpartum morbidity symptoms, perceived health system factors and cultural belief. The results revealed that the overall utilisation of maternal PNC services was 34.7%. Utilisation of PNC at day 7, 28 and 42 post-delivery was 31.6%, 11.7% and 3.6% respectively. Number of previous pregnancies; education level of mother and husband, were significantly associated with utilisation of maternal PNC at day 7 and 28 combined with 42. Only husband's education was significantly associated with overall PNC utilisation within 42 days post -delivery. In the multi variable logistic regression (LR) model, women with husbands with primary education and above were 2.4 times more likely to utilise maternal PNC within 42 days post-delivery compared to women with husbands without education (OR =2.4, 95% CI= 1.1-5.6). About 14.8% and 15.6% of mothers received all the recommended PNC elements at day 7 and combined day 28 and 42 respectively. Awareness that maternal PNC is important was associated with utilisation within 42 days post-delivery. About 17.4% of mothers reported postpartum morbidity symptoms. Mothers who reported seclusion period of 15-30 days, were 0.4 times less likely to utilise maternal PNC compared to seven or less days (OR = 0.4, 95% Cl = 0.1 - 0.9). The study concludes that utilisation of maternal PNC is low; and it is associated with husband's education and mother awareness on its importance. This study recommends creating awareness on importance of maternal PNC to both mothers and husbands through use of IEC materials; and sensitization of health care workers on the need for consistent provision of recommended maternal PNC service elements to all mothers.