Factors associated with Postnatal Care use among post-delivery women in Bugesera District, Rwanda

Abstract

The postnatal period is the time just after childbirth where the risks to the mother of postpartum hemorrhage and other significant morbidity are high. Maternal mortality is unacceptably high, 99% of all maternal deaths occur in developing countries. A significant proportion of maternal and newborn deaths take place within the 48 hours following delivery. Such problems can be detected and treated through postnatal care follow up visits. This study aimed to identify the factors associated with postnatal care services utilization in Bugesera District. This was a cross-sectional study. The study populations were 1661 women who gave birth from July to December 2015 and heads of health centers in Bugesera District. Data were collected using semi-structured questionnaire interviews. The sample size was 168 women from 5 health facility randomly selected. All women who delivered in health centers last six months of 2015 constituted the sampling frame. The sampling interval was calculated for each health center. The first number to start with was randomly selected. The selected mother was reached in her respective village. Data analysis was conducted using stata 11.7, bivariate and multivariate logistic regression analysis was done to determine statistical association between the outcome variable and independent variables. The recall bias for some respondents was noted and tracing mothers in their home places was not easy as well. The findings of this study showed that the utilization of postnatal care is 42.2%. Factors associated with the use of postnatal care (PNC) services were identified with a p-value < 0.05 include age, maternal education, socio economic class “ubudehe” category, ANC visits, mode of delivery and the fact that last born is alive or not. This study showed that the information about PNC influences the use of PNC: the fact of being informed about PNC, the extent of PNC information, understanding the necessity of the PNC and getting an appointment for PNC. In addition to all of these findings, the study also revealed other factors associated with PNC use including distance to reach health facility, customer care. The findings of this study have implications on future development regarding postnatal care therefore contribute in designing interventions to improve maternal PNC utilization.