Factors Influencing Utilization of Postnatal Care Services among Women of reproductive Age Attending Child Welfare Clinic at Kisii Teaching and Referral Hospital-Kenya

Abstract

It is a disaster to witness mothers and their young ones losing their lives from preventable maternity related causes, 30 – 40% of maternal deaths in Africa are due to hemorrhage, mostly in postpartum period. A large proportion of maternal deaths occur during the first 48 hours after delivery. Yet this is when coverage and programs are at their lowest along the continuum of care. In Sub-Sahara Africa only 13% attended postnatal care, 57% utilized PNC services in Kenya, while in Nyanza region where Kisii County falls under had the highest post neonatal mortality 31/1000 live births (KDHS, 2014). The objective of the study was to determine the factors that influenced utilization of postnatal care services among women of reproductive age attending Kisii Teaching and Referral Hospital. It was a descriptive cross-sectional study that utilized quantitative techniques targeted 268 mothers with children aged 7 to 14 weeks who attended child welfare clinic. Data was collected using semi-structured and pretested interviewer administered questionnaires and analyzed using IBM SPSS version 23 after cleaning, coding and entry. Logistic regression was fitted, possible association and statistical significance were measured using odds ratio at 95% confidence interval and P<0.05. The research was approved by Kenyatta National Hospital/ University of Nairobi Ethics Review Committee, also informed consent was obtained from all participants after fully explanation of the study design and purpose. Overall, it is about 35.8% of the participants, who utilized postnatal services, 70% of the participants were aged between 21 to 30 years. Participants who were employed were more likely to utilize postnatal care services (OR 2.1, 95% CI 1.1 to 4.0, P=0.022). Furthermore, participants who were taught about postnatal care services during the antenatal clinic were more likely to utilize postnatal care services (OR 2.3, 95% CI 1.2 to 4.4, P=0.008). Morbidity and Mortality occasioned by majority (64%) who were found not to have utilized PNC services will continue to pose serious challenges in effort towards addressing maternal and child care. Place of delivery, accessibility to health facility, teaching about PNC during ANC visit and health work force had direct association with PNC utilization. There is need for enhanced advocacy and communication to the mothers on the importance of PNC services and scheduling mothers based on the national PNC follow-up would increase the utilization.