Determinants of postnatal care utilization and maternal practices in rural areas of Lao People's Democratic Republic: a community-based cross-sectional study.

BACKGROUND

Postnatal care (PNC) contributes to reducing maternal and newborn mortality and morbidity. This study aims to identify the utilization of PNC and factors associated with receiving at least two PNC services for mothers and babies in Lao People’s Democratic Republic (Lao PDR).

METHODS

A cross-sectional study was conducted involving 533 women at 6–12 weeks postpartum in Vientiane, Bolikhamsai, and Khammouane Provinces from October to December 2022. Socio-demographic factors, obstetrics and infant factors, attitudes towards visiting health facilities and PNC, and knowledge, attitudes, and practice of maternal and child health were collected. The utilization of PNC for women and for babies was analyzed. Logistic regression analyses were performed on having two PNC services or more for mothers and babies.

RESULTS

Most mothers were 19–29 years old, had education at secondary school, had four or more antennal care visits, and had childbirth at health facilities. The coverage of PNC within the 24 h after birth (PNC 1) for mothers was 77.9% and PNC 1 for newborns was 84.2%. The coverage of two or more PNC services for both mothers and their babies was 43.3%. More than 90% of the women had an educational session on breastfeeding and took iron supplements after their most recent childbirth, approximately 80% used appropriate contraception methods, and 62.7% completed vaccinations for their most recent babies according to the baby’s age. Approximately 10% of women reported that factors such as income, distance, and transportation serve as barriers to accessing PNC. Factors associated with having two or more PNC services for mothers and babies were being single/divorced, having a monthly household income ≥ 1,000,000 Lao Kip (approximately 45 USD), living outside the city, and having the most recent childbirth at health facilities.

CONCLUSIONS

While PNC 1 coverage was relatively high, continued PNC services remained low. Promoting institutional delivery with a minimum 24-hour stay postpartum may improve PNC uptake. The Lao government should consider reintroducing targeted financial support for postpartum women, especially for those with a low-income. Strengthening community outreach through local health workers and culturally appropriate education can further enhance access to and uptake of PNC.