Perera Upuli Amaranganie Pushpakumari, Assefa Yibeltal, Amilani Uttara
Ministry of Health, Colombo, Sri Lanka.
The University of Queensland, Brisbane, Australia.
BMC Pregnancy Childbirth. 2021 Apr 13;21(1):299. doi: 10.1186/s12884-021-03770-0.
Postnatal care (PNC) is important for preventing morbidity and mortality in mothers and newborns. Even though its importance is highlighted, PNC received less attention than antenatal care. This study determines the level of PNC coverage and its determinants in Srilanka.
This is a secondary analysis of the 2016 Demographic and Health Survey. Receiving full postnatal care (FPNC) was defined with a set of indicators to detect adequate care for mother and newborn. Demographic and socio-economic associated factors for receiving FPNC were identified using binary and multiple logistic regression. Variables that had marginal relationship with receiving FPNC which p-value less than or equal to 0.2 at binary analysis were selected and included in the multiple logistic regression models. We used manual backward stepwise regression to identify variables which had independent association with receiving FPNC on the basis of adjusted odds ratios (AOR), with 95% confidence interval (CI) and p-value less than 0.05. All analyses were performed in SPSS 25.
Of the 8313 women with a live birth in the last 5 years, more than 98% had received postnatal care at facility at least 24 h. More than three-fourth of mothers (n = 5104) received the FPNC according to WHO guideline. Four factors were positively associated with receiving FPNC: mothers received antenatal home visits by Public health midwife (AOR = 1.98, 95% CI 1.65-2.39), mothers who got information about antenatal complications and places to go at antenatal clinics (AOR = 1.56, 95% CI 1.27-1.92), been Sinhala (AOR = 1.89, 95% CI 1.35-2.66) and having own mobile phone (AOR = 1.19, 95% CI 1.02-1.38). Mothers who are residing in rural area (AOR = 0.697 95% CI = 0.52-0.93] compared to those who reside in urban areas and maternal age between 20 and 34 years [AOR = 0.72, 95% CI 0.54-0.97] compared to maternal age less than 20 years were detected as negatively associated.
Receiving FPNC in Srilanka is high. However, inequity remains to be a challenge. Socio-demographic factors are associated with FPNC coverage. Strategies that aim to improve postnatal care should target improvement of non-health factors as well.
产后护理（PNC）对于预防母亲和新生儿的发病和死亡至关重要。尽管其重要性已得到强调，但产后护理受到的关注仍少于产前护理。本研究确定了斯里兰卡产后护理的覆盖水平及其决定因素。
这是对2016年人口与健康调查的二次分析。通过一组指标来定义接受全面产后护理（FPNC），以检测对母亲和新生儿的充分护理。使用二元和多元逻辑回归确定接受FPNC的人口统计学和社会经济相关因素。在二元分析中选择与接受FPNC有边缘关系且p值小于或等于0.2的变量，并纳入多元逻辑回归模型。我们使用手动向后逐步回归，根据调整后的优势比（AOR）、95%置信区间（CI）和p值小于0.05来确定与接受FPNC有独立关联的变量。所有分析均在SPSS 25中进行。
在过去5年中有活产的8313名妇女中，超过98%的人至少在医疗机构接受了24小时的产后护理。超过四分之三的母亲（n = 5104）根据世界卫生组织指南接受了FPNC。四个因素与接受FPNC呈正相关：母亲接受公共卫生助产士的产前家访（AOR = 1.98，95% CI 1.65 - 2.39）、在产前诊所获得产前并发症信息和就诊地点的母亲（AOR = 1.56，95% CI 1.27 - 1.92）、僧伽罗族（AOR = 1.89，95% CI 1.35 - 2.66）以及拥有自己的手机（AOR = 1.19，95% CI 1.02 - 1.38）。与居住在城市地区的母亲相比，居住在农村地区的母亲（AOR = 0.697，95% CI = 0.52 - 0.93）以及与年龄小于20岁的母亲相比，年龄在20至34岁之间的母亲（AOR = 0.72，95% CI 0.54 - 0.97）被检测为呈负相关。
在斯里兰卡接受FPNC的比例很高。然而，不平等仍然是一个挑战。社会人口因素与FPNC覆盖相关。旨在改善产后护理的策略也应针对非健康因素的改善。
