Abstract:
Background: Maternal and neonatal mortality remains a major problem across much of
the developing world especially Sub-Saharan Africa. In Ethiopia, even though most
maternal and infant deaths occur during postpartum, it is the most neglected period of care
provision. In Ethiopian rural community, utilization of postnatal care service is very low
but evidence on factors contributing to non-utilization of postnatal care is insufficient.
Therefore, this study was to assess factors that deter postnatal service utilization, fill some
of the gaps of previous studies and add knowledge to solve bottlenecks in postnatal
service utilization.
Objective: To identify the determinants of postnatal service non-utilization among
mothers who gave birth from July 1 to Dec 31/2018 in Demba Gofa rural district,
Southern Ethiopia.
Methods and materials: A community based unmatched case-control study was
conducted among 372 mothers (cases=186 and controls=186) who were in the 6th week
to 6 months after delivery during data collection period. A pretested questionnaire was
used for data collection. Complete data entered to Epi Data version 3.1 and export to
SPSS version 21 for analysis. Bivariate analysis was performed; Odds Ratios (ORs) and
their 95% Confidence Intervals (CIs) were calculated. Then, multivariable logistic
regression was used to control for possible confounders. P-value less than 0.05 were
considered statistically significant.
Result: In this study, 186 cases and 186 controls were interviewed. Ever not hearing
about PNC (AOR: 5.25, 95% CI: [2.09, 13.19]), home delivery (AOR: 8.01, 95%CI:
[4.23, 15.20]), women not know postnatal danger signs (AOR: 3.40, 95% CI: [1.80,
6.39]), unable to make independent decision (AOR:9.34 , 95% CI: [3.18, 27.39]), and
being not model family graduate (AOR:5.65, 95 % CI: [2.84, 11.23]) were found to have
higher chance of not utilizing postnatal care service.
Conclusion: Encouraging institutional delivery along with integrated health education
about postnatal care and postnatal danger signs, empowering women to execute
independent decision about their PNC utilization and strengthening model family
graduation will improve postnatal care service utilization.
