Determinants of postnatal care service non-utilization in Demba Gofa rural district, Southern Ethiopia

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.