Tesfaye Gezahegn, Chojenta Catherine, Smith Roger, Loxton Deborah
School of Public Health, College of Health and Medical Sciences, Haramaya University, Po Box: 235, Harar, Ethiopia; Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
Midwifery. 2019 Mar;70:22-30. doi: 10.1016/j.midw.2018.12.002. Epub 2018 Dec 4.
Postnatal care is critical to detect and manage postpartum complications in the early stages as well as to prevent potentially life-threatening health conditions that lead to maternal death. However, postnatal care utilization is persistently low in Ethiopia. The aim of this study is to assess the magnitude and correlates of postnatal care utilization among reproductive aged women in Kersa district, in eastern Ethiopia.
A community based cross-sectional study was conducted in ten randomly selected sub-districts in Kersa district. Respondents were recruited using systematic random sampling techniques. Data were collected by an interviewer-administered questionnaire using iPads. A total of 1206 respondents' data were considered in the analysis. Frequency and percentage distributions of the variables were performed. Bivariate and multivariate logistic regression analyses were undertaken to identify the predisposing, enabling and need factors associated with postnatal care utilization. An Odds Ratio with 95% confidence interval was used to ascertain the direction and strength of the association.
Less than one in thirteen women attended postnatal care after their last delivery in the study community. The multivariate analysis demonstrated that postnatal care utilization is associated with receiving education on maternal health, best friend's use of maternal care, head of the household, and experience of postpartum complications. Receiving education on maternal health (AOR, 2.32; 95% CI: 1.38, 3.89) and best friend's use of maternal care (AOR, 2.41; 95% CI: 1.39, 4.19) were significant predisposing factors that independently predicted postnatal care utilization. Furthermore, head of the household was a significantly associated enabling factor for postnatal care utilization (AOR, 0.24; 95% CI: 0.07, 0.81). The experience of postpartum complications (AOR, 0.10; 95% CI: 0.05, 0.20) was the only need factor that was associated with postnatal care utilization.
Postnatal care utilization is extremely low in the study district. Strengthening health education and promotion activities on maternal health, peer education programs within the women's social networks, strengthening women empowerment programs, and women's mobilization to seek postnatal care before the occurrence of complications are essential actions that can improve postnatal care utilization.
产后护理对于在早期阶段发现和处理产后并发症以及预防可能危及生命的健康状况（这些状况会导致孕产妇死亡）至关重要。然而，埃塞俄比亚的产后护理利用率一直很低。本研究的目的是评估埃塞俄比亚东部克萨区育龄妇女产后护理利用的程度及其相关因素。
在克萨区随机选择的10个分区开展了一项基于社区的横断面研究。采用系统随机抽样技术招募受访者。数据通过使用iPad的访谈式问卷收集。分析中纳入了总共1206名受访者的数据。对变量进行了频率和百分比分布分析。进行了二元和多元逻辑回归分析，以确定与产后护理利用相关的易患因素、促成因素和需求因素。使用具有95%置信区间的比值比来确定关联的方向和强度。
在研究社区中，每13名妇女中不到1人在其最后一次分娩后接受了产后护理。多变量分析表明，产后护理利用与接受孕产妇健康教育、最好的朋友使用孕产妇护理服务、户主以及产后并发症经历有关。接受孕产妇健康教育（调整后比值比，2.32；95%置信区间：1.38，3.89）和最好的朋友使用孕产妇护理服务（调整后比值比，2.41；95%置信区间：1.39，4.19）是独立预测产后护理利用的重要易患因素。此外，户主是与产后护理利用显著相关的促成因素（调整后比值比，0.24；95%置信区间：0.07，0.81）。产后并发症经历（调整后比值比，0.10；95%置信区间：0.05，0.20）是与产后护理利用相关的唯一需求因素。
研究区的产后护理利用率极低。加强关于孕产妇健康的健康教育和促进活动、妇女社交网络内的同伴教育项目、加强妇女赋权项目以及在并发症发生前动员妇女寻求产后护理是可以提高产后护理利用率的重要行动。
