A study to determine factors contributing to underutilization of postnatal care services in monze, choma, chikankata and chongwe districts

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Date
2013-06-12
Authors
Sicheeba, M. C.
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Publisher
The Universirty of Zambia
Abstract
The Postnatal period or puerperium begins one hour after delivery of the placenta and continues until six weeks after birth during which the mother undergoes a transitional period of recovery from physiological changes of pregnancy, trauma of labour and delivery. During this period, care is provided to the mother and her newborn in order to promote healthy behaviours such as infant feeding, and to identify and manage complications if and when they arise.Research has indicated that postnatal mothers are underutilising postnatal care services due to various factors. The aim of the study was to determine factors related to underutilisation of postnatal care services in the four district of Zambia namely; Chongwe, Monze, Choma and Chikankata. The relevant literature review was on global, regional and national level.The theoretical framework that guided the study was on knowledge of utilisation of postnatal care services, attitude and cultural beliefs towards utilisation of postnatal care services.This quantitative descriptive study using a cross section design involved consenting mothers who attended postnatal care services between six days and six week after delivery. The respondents were chosen using convenient sampling method. Data was collected from 200 mothers, 50 from each district. A semi structured interview schedule was used to collect data from the respondents and data was analysed using Statistical Package for Social Sciences Version 16.0 and a scientific calculator. Chi square test was used to describe the relationship between attendance and knowledge on postnatal care services, age, parity, educational level and, socio cultural practices including relationship between waiting time and staff attitude.The study results indicate that 32.5% (65) were aged between 15 and 19 years, 51% (102)were housewives, 70.5% (141) had 1 -3 children and 50% (100) had attained secondary school education. The study revealed high knowledge of postnatal care services among mothers (68%). 87.5% of mothers had heard about postnatal care services and the majority 93% heard from health professionals. However, mothers' main reason for attending postnatal clinic was to have their infants immunised 71%. Another major finding was that 77.5% of mothers delivered their youngest child at the health institution, 80.7% were advised to attend postnatal clinic by the health provider but only 52% attended postnatal clinic at six days and six weeks.Most mothers, 52.5%, who attended postnatal care services were not examined by a health professional. Of the 95 who were examined, 47.4% were not adequately examined. Most mothers 43% lived within 2km from the health facility and did not incur any cost to access the health facilities and 96% were pleased with reception of the health professional at the health facility.Regarding socio cultural practices most mothers stated that they observed some socio cultural practices 51.5% and mainly practiced seclusion during puerperium 73.1%.The current study showed a signficant association between the mothers' knowledge levels and attendance of postnatal clinic (P Value 0.000) as well as waiting time and staff attitude (P value 0.003). Based on the results of the study it was recommended that the Ministry of Health should develop or formulate protocol guidelines on the components of Information, Education and Communication on postnatal care in order to improve on the quality and content of information, Education Care to be given to mothers. The Ministry of Health should also intensify on conducting refresher courses for health care providers so as to keep them abreast with new trends in health care delivery. The District Health Management Teams/Hospital management should improve on supervision of health care provision in the health centres to ensure that improved and updated standards of care are offered.
Description
Postnatal mothers underutilising postnatal care services due to various factors. The aim of the study was to determine factors related to underutilisation of postnatal care services in the four district of Zambia namely; Chongwe, Monze, Choma and Chikankata.
Keywords
Postnatal care , Postnatal care --Zambia
Citation
Sicheeba, M. C. (2013) A study to determine factors contributing to underutilization of postnatal care services in monze, choma, chikankata and chongwe districts