Determinants of Early Postnatal Care Attendance in Uganda: Further Analysis of the 2016 Demographic and Health Survey
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
DHS Working Papers
Abstract
The first two days after childbirth present the highest risk of dying for a mother. Providing
postnatal care within the first two days after childbirth can help avert maternal mortality because it allows
early detection of problems that could result in adverse maternal health outcomes. Unfortunately,
knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed
at reducing maternal mortality, remains low in Uganda. Therefore, the purpose of this study is to investigate
the determinants of early postnatal care attendance among Ugandan women of reproductive age.
Methods: This study was based on nationally representative data from the 2016 Uganda Demographic and
Health Survey (UDHS). The study sample comprised 5,471 women of reproductive age 15–49 who
delivered a child in the 2 years preceding the survey. We used logistic regression to identify factors
associated with use of early postnatal care. Andersen’s Behavioral Model of health services utilization
guided the selection of independent variables.
Results: Our findings showed that 50% of mothers used EPNC services for their most recent delivery in
the 2 years preceding the survey. Women’s residence, education level, religion, wealth status, marital status,
occupation, antenatal care (ANC) attendance, place of delivery, birth order, perceived accessibility of health
facilities, and access to mass media messages were associated with greater use of EPNC. Women in urban
areas were more likely to use EPNC than women in rural areas, at 63% versus 46%. Nearly two-thirds of
the women with secondary education or higher (64%) received EPNC compared with less than half of
women with no education (47%) and women with a primary education (44%).
Receipt of EPNC was more common among women who attended at least four ANC visits for their most
recent birth, at 54%, versus 43% among women who did not receive the recommended four or more ANC
visits. The percentage of women receiving EPNC was much higher among women who delivered at a health
facility, either a public facility (63%) or private facility (65%), versus only 9% among women who delivered
at home. Multivariate analysis showed that delivery at a health facility was the most important determinant
of early postnatal care attendance. Even so, the fact that only about two-thirds of women who delivered at
a health facility received early postpartum care shows substantial room for improvement.
Conclusion: To increase mothers’ use of EPNC services and improve maternal survival in Uganda, policies
and programs could promote and strengthen health facility delivery and ensure that EPNC services are
provided to all women before discharge. Interventions should target women who deliver at home, women
who attend fewer than four ANC visits, and women with a primary education.
Description
Keywords
Early postnatal care, Demographic and Health Survey, Determinants of EPNC utilization, Place of delivery
Citation
Ndugga, P., Namiyonga, N. K., & Sebuwufu, D. (2019). Determinants of early postnatal care attendance in Uganda: further analysis of the 2016 demographic and health survey. DHS Working Papers, (148).