Faculty of Social Sciences, Department of Population Studies, University of Botswana, Gaborone, Botswana.
BMC Health Serv Res. 2024 Feb 9;24(1):185. doi: 10.1186/s12913-024-10636-6.
Over time, Uganda has experienced high levels of maternal mortality (435 deaths per 100,000 live births in 2006 to 336 deaths per 100,000 live births in 2016). The persistence of high levels of maternal mortality jeopardizes the achievement of Sustainable Development Goal (SDG) 3.1, which calls for reducing maternal mortality to 70 deaths per 100,000 live births by 2030. Conversely, the utilization of postnatal care (PNC) services in Uganda remained very low and has varied across regions. This study examined the individual and community-level factors influencing women's utilization of postnatal care services in Uganda.
Secondary data from the 2016 Uganda Demographic and Health Survey (UDHS) were used in this study. The study population consisted of women aged 15 to 49 who reported giving birth in the five years preceding the 2016 UDHS survey. The factors associated with postnatal care services were identified using multilevel binary logistic regression and spatial analysis.
The result shows that the prevalence of postnatal care service utilization in Uganda was low (58.3%) compared to the World Health Organization (WHO) target of 100%. The univariate analysis shows that 13.7% of women were adolescents, 79% were of higher parity, and 70.4% had primary/no formal education, of which 76.6% resided in rural areas. On the other hand, the multilevel analysis results showed that women aged 20-29 years and 30-39 years were also found to be more likely to use PNC services (AOR = 1.2, 95% CI: 1.01-1.47). Women who received quality ANC (AOR = 2.1, 95% CI: 1.78-2.36) were more likely to use postnatal care services than their counterparts. At the community level, women who lived in media-saturated communities were more likely to use postnatal care services (AOR = 1.3, 95% CI: 1.01-1.65). The spatial analysis found that the Central, Eastern, and Northern regions were the areas of hotspots in the utilization of postnatal care services.
This study found that age, parity, level of education, place of residence, employment status, quality of the content of antenatal care, and community media saturation were the predictors of postnatal care service utilization. The spatial analysis showed that the spatial distributions of postnatal care service utilization were significantly varied across Uganda. The government must expand access to various forms of media throughout the country to increase PNC utilization.
乌干达长期以来一直面临较高的产妇死亡率（2006 年每 10 万例活产中有 435 例死亡，2016 年降至每 10 万例活产中有 336 例死亡）。产妇死亡率居高不下，危及可持续发展目标 3.1 的实现，该目标呼吁到 2030 年将产妇死亡率降低到每 10 万例活产 70 例死亡。相反，乌干达的产后护理（PNC）服务利用率仍然很低，而且各地区差异很大。本研究考察了影响乌干达妇女利用产后护理服务的个人和社区层面的因素。
本研究使用了 2016 年乌干达人口与健康调查（UDHS）的二级数据。研究人群由在 2016 年 UDHS 调查前五年内报告分娩的 15 至 49 岁妇女组成。利用多水平二项逻辑回归和空间分析确定与产后护理服务相关的因素。
结果显示，乌干达的产后护理服务利用率较低（58.3%），低于世界卫生组织（WHO）设定的 100%的目标。单因素分析显示，13.7%的妇女为青少年，79%为多胎次，70.4%接受过小学/非正规教育，其中 76.6%居住在农村地区。另一方面，多水平分析结果表明，20-29 岁和 30-39 岁的妇女也更有可能使用 PNC 服务（AOR=1.2，95%CI：1.01-1.47）。接受优质 ANC 的妇女（AOR=2.1，95%CI：1.78-2.36）更有可能使用产后护理服务。在社区层面，生活在媒体饱和社区的妇女更有可能使用产后护理服务（AOR=1.3，95%CI：1.01-1.65）。空间分析发现，中部、东部和北部地区是产后护理服务利用的热点地区。
本研究发现，年龄、胎次、教育程度、居住地、就业状况、产前护理内容质量以及社区媒体饱和是产后护理服务利用的预测因素。空间分析表明，乌干达各地产后护理服务的空间分布差异显著。政府必须在全国范围内扩大各种形式媒体的获取途径，以提高 PNC 的利用率。
