Low utilization of postnatal care: searching the window of opportunity to save mothers and newborns lives in Islamabad capital territory, Pakistan

BMC Research Notes

Babar Tasneem Shaikh¹  Nighat Sultana¹ 

[1] Department of Health Systems and Policy, Health Services Academy, Park Road, Chak Shahzad, Islamabad 44000, Pakistan

关键词: Pakistan;    Newborn and child health;    Maternal;    Reproductive health services;    Postnatal care;   

Others  :  1232800
DOI  :  10.1186/s13104-015-1646-2

 received in 2015-06-26, accepted in 2015-10-28,  发布年份 2015

【 摘 要 】

Background

Each year an estimated 289,000 maternal deaths occur worldwide; of which 50 % of maternal deaths occur around labor, delivery and immediate postpartum period. Postnatal care (PNC) is crucial but relatively neglected component in the continuum of care, and hence a missing link toward safe motherhood. Despite the significant improvement in child health and safe motherhood interventions, maternal mortality ratio, perinatal mortality and neonatal mortality still remain a challenge in achieving the Millennium Development Goals 4 and 5 in Pakistan.

Methods

This was a descriptive cross sectional study carried out in the four union councils of Islamabad capital territory, to understand the determinants of postnatal health care seeking. The study sample comprised 225 postpartum women with a child 0 to 1 month of age, and the health care providers from both public and private sector. A pre-tested semi-structured questionnaire was used for data collection. One focus group discussion with health care providers was conducted, using open ended questions guide.

Results

Only 30 % women received PNC; amongst which 68 % went to a government health facility. According to the health service providers, 90 % women are not interested in PNC, and that is because they lack awareness, face mobility and transportation issues, and cannot afford the cost of health care. Besides many other determinants, women’s education was significantly associated with the PNC utilization.

Conclusion

More robust and culturally sensitive campaign on importance of PNC must be thought out by the national MNCH program to inform the less literate and peri urban inhabitants of Islamabad. Health providers ought to be sensitized and trained for promoting PNC to save maternal and newborn lives.

【 授权许可】

   
2015 Sultana and Shaikh.

【 图 表 】

Fig.1.

Fig.2.

Fig.3.

【 参考文献 】

• [1]World Health Organization: Trends in maternal mortality: 1990 to 2013. The World Bank and the United Nations Population Division. Geneva, Estimates by WHO, UNICEF, UNFPA; 2014.
• [2]Save the Children: Surviving the first day. State of the World’s Mothers, London; 2013.
• [3]Ejaz I, Shaikh BT: Social marketing for early neonatal care: saving newborn lives in Pakistan. World Health Popul 2010, 11(3):18-24.
• [4]National Institute of Population Studies and ICF International. Pakistan Demographic and Health Survey 2012–13. Islamabad; 2013.
• [5]Shaikh BT, Haran D, Hatcher J: Women’s social position and health-seeking behaviors: is health care system accessible and responsive in Pakistan? Health Care Women Int 2008, 29(8/9):945-959.
• [6]World Health Organization. Maternal, newborn, child and adolescent health. Postnatal care. http://www.who.int/maternal_child_adolescent/topics/newborn/postnatal_care/en/. Accessed 18 Aug 2014.
• [7]Singh PK, Rai RK, Alagarajan M, Singh L: Determinants of maternity care services utilization among married adolescent in rural India. PLoS ONE 2012, 7(2):e31666.
• [8]Ejaz S, Ahmad K: Postpartum care utilization among primigravida: a study in rural Punjab, Pakistan. Res Human Soc Sci 2013, 3(4):1-19.
• [9]Bord YR, Lyons K, Skinner J, Teijlingen ERV: Maternal health services utilization in Nepal: progress in the new millennium? Health Sci J 2012, 6(4):618-633.
• [10]Haque M. Individual’s characteristics affecting maternal health services utilization: married adolescents and their use of maternal health services in Bangladesh. Int J Health. 2009;8(2).
• [11]Islam MR: Determinants of antenatal and postnatal care visits among indigenous peoples in Bangladesh: a study of the Mru community. Remote Rural Health 2011, 11:1672.
• [12]Tao F, Huang K, Long X, Tolhurst R, Ravan J: Low postnatal care rates two rural counties in Anhui province, China: perception of key stakeholders. Midwifery 2011, 27(5):707-715.
• [13]Wazir S, Shaikh BT, Ahmed A: National program for family planning and primary health care Pakistan: a SWOT analysis. BMC Reprod Health 2013, 10:60. BioMed Central Full Text
• [14]Ononokpono DN, Odimegwn CO, Imasiku EN, Adedini SA: Does it really matter where women live? A multilevel analysis of the determinants of postnatal care in Nigeria. Maternal Child Health J 2014, 18:950-959.
• [15]Regassa N: Antenatal and postnatal care service utilization in Southern Ethiopia: a population-based study. Afr Health Sci 2011, 11(3):390-397.
• [16]Paras A, Singh MM, Suneela G: Maternal health care—utilization among women in an urban slum in Delhi. Ind J Comm Med 2007, 32(3):203-205.
• [17]Al Adili N, Johansson A, Bergstrom S: Maternal mortality among Palestinian women in the West Bank. Int J Gynaecol Obstet 2006, 93:164-170.