Uptake of, barriers and enablers to the utilization of postnatal care services in Thyolo, Malawi

BMC Pregnancy and Childbirth

卷:23

Research

Andrew Kumitawa¹  Marumbo Chirwa²  Alinane Linda Nyondo-Mipando³  Sangwani Salimu³  Martin Dohlsten⁴  Tedbabe D. Hailegebriel⁵  Debra Jackson⁶  Bongani Chikwapulo⁷  Jacqueline Chinkonde⁸  Mesfin Senbete⁸  Tiyese Jean Chimuna⁸  Fatima Gohar⁸ 

[1] Department of Epidemiology and Statistics, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi;

[2] Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi;

[3] Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi;Maternal and Fetal Health Group, Malawi Liverpool Wellcome Programme, Blantyre, Malawi;

[4] Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland;

[5] Health Section, Programme Division, UNICEF Headquarters, New York, NY, USA;

[6] London School of Hygiene and Tropical Medicine, London, UK;University of the Western Cape, Cape Town, South Africa;

[7] Quality Management Directorate, Ministry of Health, Lilongwe, Malawi;

[8] UNICEF Malawi Country Office, Lilongwe, Malawi;

关键词: Postnatal care;    Neonates;    Male involvement;    Community support;    Mothers;   

DOI  :  10.1186/s12884-023-05587-5

 received in 2022-05-15, accepted in 2023-04-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPostnatal care (PNC) ensures early assessments for danger signs during the postpartum period and is to be provided within 24 h of birth, 48–72 h, 7–14 days, and six weeks after birth. This study assessed the uptake of and the barriers and facilitators to receiving PNC care among mothers and babies.MethodsA concurrent mixed-method study employing a retrospective register review and a qualitative descriptive study was conducted in Thyolo from July to December 2020. Postnatal registers of 2019 were reviewed to estimate the proportion of mothers and newborns that received PNC respectively. Focus Group Discussions (FGDs) among postnatal mothers, men, health care workers, and elderly women and in-depth interviews with midwives, and key health care workers were conducted to explore the barriers and enablers to PNC. Observations of the services that mothers and babies received within 24 h of birth, at 48–72 h, 7–14 days, and six weeks after birth were conducted. Descriptive statistics were tabulated for the quantitative data using Stata while the qualitative data were managed using NVivo and analysed following a thematic approach.ResultsThe uptake of PNC services was at 90.5%, 30.2%, and 6.1% among women and 96.5%, 78.8%, and 13.7% among babies within 48 h of birth, 3 to 7 and 8 to 42 days respectively. The barriers to PNC services included the absence of a baby or mother, limited understanding of PNC services, lack of male involvement, and economic challenges. Cultural and religious beliefs, advice from community members, community activities, distance, lack of resources, and poor attitude of health care workers also impeded the utilisation of PNC services. The enablers included the mother’s level of education, awareness of the services, economic resources, community-based health support, adequacy and attitude of health workers, seeking treatment for other conditions, and other clinic activities.ConclusionOptimisation of uptake and utilization of PNC services for mothers and neonates will require the involvement of all stakeholders. The success of PNC services lies in the communities, health services, and mothers understanding the relevance, time points, and services that need to be delivered to create demand for the services. There is a need to assess the contextual factors for a better response in improving the uptake of PNC services and in turn inform the development of strategies for optimizing the uptake of PNC services.

【 授权许可】

CC BY   
© The Author(s) 2023

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