Nuwabaine Lilian, Namulema Angella, Sserwanja Quraish, Kawuki Joseph, Amwiine Earnest, Amperiize Mathius, Nakate Mary Grace, Asiimwe John Baptist
School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
Department of Nursing, Mbarara University of Science and Technology, Mbarara city, Uganda.
Arch Public Health. 2024 Nov 27;82(1):227. doi: 10.1186/s13690-024-01433-y.
Despite the significant contribution of postnatal care (PNC) to maternal and newborn survival, few studies have explored the concept of the quality of PNC received by mothers in Kenya. Therefore, this study aimed to determine the prevalence and factors associated with the quality of PNC in Kenya.
Secondary data from the Kenya Demographic and Health Survey (KDHS) of 2022 were analyzed, comprising 11,863 women who were aged 15 to 49 years. The quality of PNC was indicated as receiving all components of PNC in the first two days after childbirth. Multivariable logistic regression was conducted to determine the factors associated with the quality of PNC, using SPSS, version 20.
Out of the 11,863 women, 39% (95% CI: 37.0-40.9) had received all components of PNC in the first two days after childbirth. Additionally, older women aged 35-49 years (AOR 1.88, 95%CI: 1.07-3.29), those who made decisions to seek health care jointly (AOR 1.48, 95%CI: 1.18-1.85), those who owned a telephone (AOR 1.36, 95%CI: 1.05-1.76), women who received quality antenatal care (AOR 4.62, 95%CI: 3.69-5.76), older women aged 30-34 years at the time of their first childbirth (AOR 2.25, 95%CI: 1.11-4.55), those who gave birth through cesarean section birth (AOR 1.93, 95%CI: 1.49-2.49), those who gave birth at public health facilities (AOR 1.69, 95%CI: 1.01-2.82) and those who received quality intrapartum care (AOR 1.87, 95%CI: 1.43-2.43) when compared with their counterparts were more likely to receive quality PNC. On the other hand, women from other provinces of Kenya i.e., Western (AOR 0.51, 95%CI: 0.33-0.80), and Rift Valley (AOR 0.57, 95%CI: 0.39-0.81), those who gave birth to female children (AOR 0.75, 95%CI: 0.61-0.91) and those who reported to have not been respected at all times during their hospital stay (AOR 0.49, 95%CI: 0.29-0.82) when compared with their counterparts were less likely to receive quality PNC.
The proportion of mothers receiving quality PNC was found to be low. The study also highlights the need to continue encouraging mothers to attend numerous ANC visits. Moreover, emphasis should be placed on providing quality ANC, intrapartum care, and respectful maternity care by health workers. Targeted interventions to increase access to quality PNC may need to focus on young mothers, mothers living in certain regions of Kenya, and those giving birth to female babies, most especially at private health facilities, and through vaginal birth.
尽管产后护理（PNC）对孕产妇和新生儿存活做出了重大贡献，但很少有研究探讨肯尼亚母亲所接受的产后护理质量这一概念。因此，本研究旨在确定肯尼亚产后护理质量的患病率及其相关因素。
对2022年肯尼亚人口与健康调查（KDHS）的二手数据进行分析，该数据包含11863名年龄在15至49岁之间的女性。产后护理质量的指标是在分娩后的前两天接受产后护理的所有组成部分。使用SPSS 20版进行多变量逻辑回归分析，以确定与产后护理质量相关的因素。
在11863名女性中，39%（95%置信区间：37.0 - 40.9）在分娩后的前两天接受了产后护理的所有组成部分。此外，与同龄人相比，35 - 49岁的老年女性（调整后的优势比[AOR]为1.88，95%置信区间：1.07 - 3.29）、共同做出寻求医疗保健决定的女性（AOR为1.48，95%置信区间：1.18 - 1.85）、拥有电话的女性（AOR为1.36，95%置信区间：1.05 - 1.76）、接受过高质量产前护理的女性（AOR为4.62，95%置信区间：3.69 - 5.76）、首次分娩时年龄在30 - 34岁的老年女性（AOR为2.25，95%置信区间：1.11 - 4.55）、通过剖宫产分娩的女性（AOR为1.93，95%置信区间：1.49 - 2.49）、在公共卫生设施分娩的女性（AOR为1.69，95%置信区间：1.01 - 2.82）以及接受过高质量产时护理的女性（AOR为1.87，95%置信区间：1.43 - 2.43）更有可能接受高质量的产后护理。另一方面，与同龄人相比，来自肯尼亚其他省份的女性，即西部（AOR为0.51，95%置信区间：0.33 - 0.80）和裂谷地区（AOR为0.57，95%置信区间：0.39 - 0.81）、生育女孩的女性（AOR为0.75，95%置信区间：0.61 - 0.91）以及报告在住院期间一直未受到尊重的女性（AOR为0.49，95%置信区间：0.29 - 0.82）接受高质量产后护理的可能性较小。
发现接受高质量产后护理的母亲比例较低。该研究还强调需要继续鼓励母亲参加多次产前护理访视。此外，应强调卫生工作者提供高质量的产前护理、产时护理和尊重产妇的护理。增加获得高质量产后护理机会的有针对性干预措施可能需要关注年轻母亲、生活在肯尼亚某些地区的母亲以及生育女婴的母亲，尤其是在私立卫生设施，以及通过阴道分娩的情况。
