Perinatal care in Western Uganda: Prevalence and factors associated with appropriate care among women attending three district hospitals
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
PloS one
Abstract
Perinatal mortality remains high globally and remains an important indicator of the quality of
a health care system. To reduce this mortality, it is important to provide the recommended
care during the perinatal period. We assessed the prevalence and factors associated with
appropriate perinatal care (antenatal, intrapartum, and postpartum) in Bunyoro region,
Uganda. Results from this study provide valuable information on the perinatal care services
and highlight areas of improvement for better perinatal outcomes.
Methods
A cross sectional survey was conducted among postpartum mothers attending care at three
district hospitals in Bunyoro. Following consent, a questionnaire was administered to capture
the participants’ demographics and data on care received was extracted from their
antenatal, labour, delivery, and postpartum records using a pre-tested structured tool. The
care received by women was assessed against the standard protocol established by World
Health Organization (WHO). Poisson regression with robust standard errors was used to
assess factors associated with appropriate postpartum care.
Results
A total of 872 mothers receiving care at the participating hospitals between March and June
2020 were enrolled in the study. The mean age of the mothers was 25 years (SD = 5.95).
None of the mothers received appropriate antenatal or intrapartum care, and only 3.8% of the participants received appropriate postpartum care. Factors significantly associated with
appropriate postpartum care included mothers being >35 years of age (adjusted prevalence
ratio [aPR] = 11.9, 95% confidence interval [CI] 2.8–51.4) and parity, with low parity (2–3)
and multiparous (>3) mothers less likely to receive appropriate care than prime gravidas
(aPR = 0.3, 95% CI 0.1–0.9 and aPR = 0.3, 95% CI 0.1–0.8 respectively).
Conclusions
Antenatal, intrapartum, and postpartum care received by mothers in this region remains
below the standard recommended by WHO, and innovative strategies across the continuum
of perinatal care need to be devised to prevent mortality among the mothers. The quality of
care also needs to be balanced for all mothers irrespective of the age and parity.
Description
Keywords
Perinatal care, Western Uganda, Women, District hospitals
Citation
Muwema M, Kaye DK, Edwards G, Nalwadda G, Nangendo J, Okiring J, et al. (2022) Perinatal care in Western Uganda: Prevalence and factors associated with appropriate care among women attending three district hospitals. PLoS ONE 17(5): e0267015. https://doi.org/10.1371/ journal.pone.0267015