Population attributable risk estimates for factors associated with non-use of postnatal care services among women in Nigeria.

Introduction: The World Health Organization recommends that women should be given postnatal care within the first 24 hours, followed by check-ups on the second or third day, and then on the seventh day after giving birth. There is evidence that most maternal deaths occur during labour, delivery or the first 24 hours postpartum (after delivery).

The researchers looked at data from the 2013 NDHS survey of 20,467 mothers between the ages of 15-49 years, who had delivered babies within 5 years prior to the survey. The study was to estimate the proportion of mothers who do not receive postnatal care (PNC) in relation to why they do not seek PNC.

Participants and their household filled out questionnaires assessing their health knowledge (frequency of which they read newspapers, listened to radio, watched TV and if they were aware of delivery complications), Demographics (which included mothers age at delivery, household income, child’s sex) and social structures like level of education, marital status, birth spacing. In addition to that, they put into consideration community-level factors (geopolitical zone and place of residence) and enabling factors (which included permission to visit health services, the distance of health services, presence of a companion, getting money to pay health services, the behavior of health workers).

PNC which is the care given in the first 6 weeks after a woman gives birth is crucial to maintain and promote the health and survival of the mother and her newborn.  38% of children under the age, 5 who die, do so during the first 28 days after birth. This number can reduce if PNC is received. PNC gives the health professional the opportunity to detect, monitor and treat any health concerns found in the mother and her baby. In addition, it is a time to promote and encourage breastfeeding, hygiene and introduce family planning counseling and services.

Conclusion:

The study concluded that the majority of Nigerian women do not utilize PNC services. The results from the study showed that among women who do not use PNC, 68% had delivered at home, 61% were delivered by non-health professionals and 37% of the women lacked any knowledge of delivery complications.

The importance of this study is that it identifies factors associated with non-use of PNC which would be beneficial to policymakers in providing interventions like mother education, providing home delivery services which will help curb cultural practices preventing women from seeking PNC that are prevalent in rural areas and lastly financial support by the government to access trained health professional.

Written by Dr. Vivien Edi MD

References: Agho KE, Ezeh OK, Issaka AI, et al Population attributable risk estimates for factors associated with non-use of postnatal care services among women in Nigeria BMJ Open 2016;6:e010493. doi: 10.1136/bmjopen-2015-010493

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