Factors affecting postnatal care services utilization in Male, Maldives

Abstract

Postnatal care is one of the important components for maternal health, especially for managing post-delivery complications. A facility-based cross-sectional study was conducted in the Urban Primary Healthcare Centre (Dhamanaveshi) in Male', Maldives in 2020 among the women with one or more children up to 1 year of age to assess the prevalence of postnatal care utilization and the factors associated with postnatal care utilization. The Systematic random sampling technique was used to select 223 participants. A structured questionnaire was used to collect data by interviewing the participants. The outcome variable of interest was to see whether the participants completed PNC utilization within the recommended WHO time frame or not. Data was entered in SPSS. The Chi-square test was applied to identify the association between the independent variables and the outcome variable. The Odd ratio with 95% confidence interval and p-value less than 0.05 was computed to determine the level of significance. The prevalence of PNC utilization was 54.7%. The study revealed that, among predisposing factors, there was the significant association between respondent's and husband's education level, respondent's occupation, family type, exposure to mass media, monthly household income and perception about income, type of health insurance, completed ANC for the last child, mode of delivery, place of delivery of the last child and traditional beliefs and practices and PNC services utilization (p-value <0.05). In addition, among the enabling factors, distance from health facility, satisfaction towards waiting time, perception about travel to health facility, cost of transport and social support were found to be significantly associated (p-value <0.05). Lastly, all the need factors i.e; experience of complication due to pregnancy/delivery, health education after delivery and pregnancy intention were significantly associated with PNC utilization (p-value <0.05). Hence, it's important that during ANC advices provided emphasize on the importance of PNC to both mother and baby, the health facilities should use mass media- especially social media platforms especially facebook, youtube and twitter to increase awareness among the mothers, husbands and their families, better public transport options and strengthening health education that is given immediately after delivery could be supportive factors to further promote PNC utilization among the mothers.