Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
Berekum College of Education, Berekum, Bono Region, Ghana.
PLoS One. 2021 Apr 2;16(4):e0249480. doi: 10.1371/journal.pone.0249480. eCollection 2021.
Early postnatal care (EPNC) utilisation is crucial for averting maternal deaths as recommended by the World Health Organisation. About 30% of women do not obtain EPNC in Ghana and no national level study have investigated the determinants of EPNC. Therefore, this study aimed at assessing factors associated with EPNC uptake among women aged 15-49 in Ghana.
The study utilised data from the women's file of the 2014 Ghana Demographic and Health Survey (GDHS) and sampled 1,678 women aged 15-49 who had complete data on EPNC. Descriptive computation of EPNC was done. Since EPNC (which is the main outcome variable for the study) was dichotomous, the binary logistic regression was used to determine factors influencing utilisation of EPNC at 95% two-tailed confidence interval. The results were presented as adjusted odds ratio (AOR). Stata version 14.0 was used for all the analyses.
Descriptively, the results indicated that 31% of women aged 15-49 sought EPNC. At the inferential level, women aged 40-44 were more likely to seek EPNC compared to those aged 15-19 [AOR = 3.66, CI = 1.25-10.67]. Islam women had higher odds of EPNC as compared with Christians [AOR = 1.70, CI = 1.23-2.35]. Comparatively, women of Mande ethnic group had higher propensity to seek EPNC than the Akan [AOR = 3.22, CI = 1.20-8.69]. Residents of the Greater Accra region were over 11 times probable to utilise EPNC compared with the residents of Western region.
The key determinants of EPNC were age, religion, ethnicity, marital status and region. Therefore, the Health Promotion and Education Unit and Reproductive and Child Health Department of the Ghana Health Service need to scale up EPNC sensitisation programmes and should target women aged 15-19, Christians and other category of women with less likelihood of EPNC in order to offset the disparities.
世界卫生组织建议，开展早期产后护理（EPNC）可有效避免产妇死亡。在加纳，约有 30%的女性无法获得 EPNC，且尚无全国性研究调查 EPNC 利用的决定因素。因此，本研究旨在评估加纳 15-49 岁女性获得 EPNC 的相关因素。
本研究使用了 2014 年加纳人口与健康调查（GDHS）女性档案中的数据，抽取了 1678 名年龄在 15-49 岁之间、EPNC 数据完整的女性。对 EPNC 进行了描述性计算。由于 EPNC（本研究的主要结果变量）为二分变量，因此使用二元逻辑回归确定了 95%双侧置信区间内影响 EPNC 利用的因素。结果表示为调整后的优势比（AOR）。所有分析均使用 Stata 版本 14.0。
描述性结果表明，15-49 岁的女性中有 31%寻求 EPNC。在推断性水平上，40-44 岁的女性比 15-19 岁的女性更有可能寻求 EPNC[AOR=3.66，CI=1.25-10.67]。与基督徒相比，穆斯林女性接受 EPNC 的可能性更高[AOR=1.70，CI=1.23-2.35]。相比之下，与阿坎族相比，曼德族女性寻求 EPNC 的可能性更高[AOR=3.22，CI=1.20-8.69]。与西部地区的居民相比，大阿克拉地区的居民利用 EPNC 的可能性高出 11 倍以上。
EPNC 的主要决定因素是年龄、宗教、族裔、婚姻状况和地区。因此，加纳卫生服务部的健康促进和教育股以及生殖和儿童健康股需要扩大 EPNC 宣传计划，针对 15-19 岁的女性、基督徒和其他 EPNC 可能性较低的女性群体，以消除差异。
