Determinants of Post Natal Care Uptake in Bikita District, Masvingo Province, 2011

Abstract

Postnatal care (PNC) gives an opportunity to detect medical problems of the mother and neonate and reduce morbidity and mortality. In 2010 PNC uptake in Bikita was 43%. This study was conducted to determine factors associated with low PNC uptake in Bikita. Materials and methods: A 1:1 unmatched case control study was conducted. A case was defined as a woman who attended at least one antennal care visit and did not attend first( 10 day) PNC visit. A control was a woman who attended both antenatal care and first (10 day) PNC visit. Random sampling was used to select cases and controls from ANC and PNC registers at health centres. An interviewer administered questionnaire using constructs of the Health belief model was used. Focus group discussions were conducted with women who were not study participants who had come for ANC and PNC. A check list was used to asses availability of resources for use in PNC. Epi Info 3.5.1 was used to analyse data. Qualitative data was coded , grouped and analysed manually. Results: One hundred and fifty cases and 150 controls were recruited. Independent factors associated with non-uptake of PNC were; practicing seclusion until umbilical cord fell off, [AOR 3.43,( 95%CI: 1.73-6.81)], residing in village/resettlement [AOR 3.71(95%Cl: 1.30- 9.90)],delivering at home [AOR 6.0(95%CI: 3.50-12.71)], staying more than 5km from health centre [AOR 1.73(95%CI: 1.03:2.89)],. Factors associated with PNC uptake were

secondary/tertiary level of education [AOR 0.25 (95%CI: 0.11-0.73)] and ability of mother to attend PNC within 48 hours after at home delivery [AOR 0.60(95%CI: 0.21:0.96)]. Discussion and Conclusion : Delivering at home may lead to transmission of HIV from mother to child if the mother is HIV positive due to non swallowing of Nevirapine during delivery. Death of mother and neonate may occur due to lack of medically skilled assistance. Construction of more waiting mothers shelters may increase the number of institutional deliveries and prevent maternal and neonatal deaths. As a result of the findings of this study Save the Children UK has been approached to assist in the construction of waiting mothers’ shelters at Chikuku and Bikita rural hospital.Introduction: Postnatal care (PNC) gives an opportunity to detect medical problems of the mother and neonate and reduce morbidity and mortality. In 2010 PNC uptake in Bikita was 43%. This study was conducted to determine factors associated with low PNC uptake in Bikita. Materials and methods: A 1:1 unmatched case control study was conducted. A case was defined as a woman who attended at least one antennal care visit and did not attend first( 10 day) PNC visit. A control was a woman who attended both antenatal care and first (10 day) PNC visit. Random sampling was used to select cases and controls from ANC and PNC registers at health centres. An interviewer administered questionnaire using constructs of the Health belief model was used. Focus group discussions were conducted with women who were not study participants who had come for ANC and PNC. A check list was used to asses availability of resources for use in PNC. Epi Info 3.5.1 was used to analyse data. Qualitative data was coded , grouped and analysed manually. Results: One hundred and fifty cases and 150 controls were recruited. Independent factors associated with non-uptake of PNC were; practicing seclusion until umbilical cord fell off, [AOR 3.43,( 95%CI: 1.73-6.81)], residing in village/resettlement [AOR 3.71(95%Cl: 1.30- 9.90)],delivering at home [AOR 6.0(95%CI: 3.50-12.71)], staying more than 5km from health centre [AOR 1.73(95%CI: 1.03:2.89)],. Factors associated with PNC uptake were

secondary/tertiary level of education [AOR 0.25 (95%CI: 0.11-0.73)] and ability of mother to attend PNC within 48 hours after at home delivery [AOR 0.60(95%CI: 0.21:0.96)]. Discussion and Conclusion : Delivering at home may lead to transmission of HIV from mother to child if the mother is HIV positive due to non swallowing of Nevirapine during delivery. Death of mother and neonate may occur due to lack of medically skilled assistance. Construction of more waiting mothers shelters may increase the number of institutional deliveries and prevent maternal and neonatal deaths. As a result of the findings of this study Save the Children UK has been approached to assist in the construction of waiting mothers’ shelters at Chikuku and Bikita rural hospital.