Postnatal Care Experiences and Barriers to Care Utilization for Home- and Facility-Delivered Newborns in Uganda and Zambia
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Maternal and child health journal
Abstract
Objectives The objective of this study was to
examine experiences with, and barriers to, accessing postnatal
care services, in the context of a maternal health initiative.
Methods As part of a larger evaluation of an initiative to promote
facility deliveries in 8 rural districts in Uganda and
Zambia, 48 focus groups were held with recently-delivered
women with previous home and facility deliveries (6 per district).
Data on postnatal care experiences were translated,
coded and analyzed using thematic content analysis techniques.
Results were categorized into: positive postnatal care
experiences, barriers to postnatal care utilization, and negative
postnatal care experiences. Results Women who accessed care
largely reported positive experiences, with Zambian women
generally reporting more positive interactions than Ugandan
women. The main reasons given for low postnatal care utilization
were low awareness about the need, fear of mistreatment
by clinic staff, cost and distance. In half of the focus
groups, women described personal experience or knowledge
of denial or threatened denial of postnatal care due to the birth
location. Although outright denial of care was not common,
women frequently described various types of actual or presumed
discrimination because of having a home birth. Conclusions
for Practice While many women reported positive
experiences with postnatal care utilization, cases of delay or
denial of postnatal care exist. As programs incentivize facility
deliveries, the lack of focus on postnatal support may place
home-delivered newborns in ‘‘double jeopardy’’ due to poor
quality intra-partum care and reduced access to postnatal care.
Description
Keywords
Newborn care, Neonatal care, Postnatal care, Maternal health, Disrespectful care, Health services, Qualitative methods, Unintended consequences, Uganda, Zambia
Citation
Sacks, E., Masvawure, T. B., Atuyambe, L. M., Neema, S., Macwan’gi, M., Simbaya, J., & Kruk, M. (2017). Postnatal care experiences and barriers to care utilization for home-and facility-delivered newborns in Uganda and Zambia. Maternal and child health journal, 21(3), 599-606. DOI 10.1007/s10995-016-2144-4