Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Pregnancy Childbirth. 2021 Jan 6;21(1):22. doi: 10.1186/s12884-020-03523-5.
Postnatal care (PNC) visits provide a huge benefit for ensuring appropriate breastfeeding practices, to monitor the overall health status of the newborn, to timely diagnose and intervene birth-related complications, and to plan future family planning options. Despite delayed PNC attendance have a great impact on the survival of the mother and the newborn it still receives less emphasis. As a result, most mothers do not receive PNC services early. We, therefore, aimed to determine individual and community level factors associated with delayed first Postnatal Care attendance among reproductive age group women in Ethiopia.
We used the most recent Ethiopian Demographic and Health Survey (EDHS 2016) data to determine associated factors of delayed first PNC in Ethiopia. A weighted sample of 4308 women with a live birth in the two years preceding the survey was included. A multilevel logistic regression analysis was used to analyze the data. Variables with p-value < 0.05 in the multivariable multilevel logistic regression analysis were declared significantly associated with delayed first PNC attendance.
In this study, both individual level and community level factors were associated with delayed PNC attendance. Among the individual level factors: having four or more antenatal care visit [Adjusted Odd Ratio (AOR) = 0.73; 95% CI: 0.59, 0.92], delivery at a health facility [AOR = 0.04; 95% CI: 0.03, 0.05], and perceiving distance from the health facility as not a big problem [AOR = 0.73; 95% CI: 0.58, 0.91] were associated with lower odds of delayed first PNC attendance. Of community level factors: being in Oromia [AOR = 2.31; 95% CI: 1.38, 3.83] and Gambela [AOR = 2.01; 95% CI: 1.13, 3.56] regions were associated higher odds of delayed first PNC attendance.
Both individual level and community level factors were found to be associated with delayed PNC attendance. Strengthening antenatal care utilization, institutional delivery, and appropriate distributions of maternal health services in each region and areas far apart from the health facility are recommended.
产后护理（PNC）访视对确保适当的母乳喂养实践、监测新生儿整体健康状况、及时诊断和干预与分娩相关的并发症以及规划未来的计划生育选择有巨大益处。尽管延迟进行 PNC 会对母婴的生存产生重大影响，但它仍然没有得到足够的重视。结果，大多数母亲没有及早接受 PNC 服务。因此，我们旨在确定与埃塞俄比亚育龄妇女延迟首次产后护理就诊相关的个体和社区层面因素。
我们使用最近的埃塞俄比亚人口与健康调查（EDHS 2016）数据来确定埃塞俄比亚延迟首次 PNC 的相关因素。纳入了在调查前两年内有活产的 4308 名妇女的加权样本。使用多水平逻辑回归分析来分析数据。在多变量多水平逻辑回归分析中 p 值<0.05 的变量被宣布与延迟首次 PNC 就诊显著相关。
在这项研究中，个体层面和社区层面的因素都与延迟 PNC 就诊有关。在个体层面因素中：有 4 次或更多次产前护理就诊[校正优势比（AOR）=0.73；95%置信区间：0.59，0.92]、在医疗机构分娩[AOR=0.04；95%置信区间：0.03，0.05]和认为距离医疗机构不是大问题[AOR=0.73；95%置信区间：0.58，0.91]与较低的延迟首次 PNC 就诊可能性相关。在社区层面因素中：在奥罗米亚[OR=2.31；95%置信区间：1.38，3.83]和甘贝拉[OR=2.01；95%置信区间：1.13，3.56]地区与更高的延迟首次 PNC 就诊可能性相关。
个体层面和社区层面的因素都与延迟 PNC 就诊有关。建议加强产前护理的利用、医疗机构分娩，并在每个地区和远离医疗机构的地区适当分配孕产妇保健服务。
