Utilization of Maternal Postnatal Care Services Among Women in Selected Villages of Bahi District, Tanzania

Abstract

Tanzania is among the countries in sub-Saharan Africa with high rate of maternal mortality. Postpartum deaths caused by obstetric factors occur mainly due to limited access and use of maternal health care services. A cross-sectional study was conducted in July, 2014 in Bahi district, Central Tanzania. The objective of the study was to assess the utilization maternal postnatal care (PNC) services and determinants for its utilization. The study involved a random sample of 134 women whose last live child birth occurred within two years preceding the survey. Key issues investigated were awareness to maternal PNC services on health facilities and attitude on the services; timing and frequency of use of maternal PNC services and barriers for utilization of the services. Results show that majority of women (94.8%) were aware of the existence of maternal PNC services in health facilities. Nearly 82% of women had positive attitude towards maternal PNC services. However, only 71.6% of them used the services in their most recent child birth, 70.8% had one to two PNC visits for checkup within 42 days post delivery as opposed to the recommended three visits; and only 41.7, 45.6 and 32.1%, respectively of women that had first, second and third maternal PNC visits, attended the visits timely. Factors associated with non- use of maternal PNC services included low education level, long distance to health facilities, low household income, non-attendance to health facilities for antenatal care service, home delivery, negative attitude towards maternal PNC services and negative perception on quality of maternity health services in health facilities. Women with at least secondary education were more likely to use maternal PNC services compared to those with no formal education (OR = 1.40, p = 0.020). Likewise, women from high income families were more likely to use the services compared to the counterpart (OR = 1.67 p = 0.015). On the other hand, women living in distant areas from health facility i.e., more than 5 km from homestead, were less likely to use the services compared to the counterpart (OR = 0.75, p = 0.033). Non-use of antenatal care services (ANC) also decreased odds for use of maternal PNC services among women (OR = 0.68, p = 0.017). Results further indicate women delivered in health facilities were more likely to report use of maternal PNC services compared to those delivered at home (OR = 2.03, p = 0.004) and women who attached less importance to maternal PNC services were 58% less likely to use the services compared to the counterpart (OR = 0.42, p = 0.003), while those think that quality of maternity health services in health facilities are good were 40% more likely to use maternal PNC services compared to the counterpart (OR = 1.40, p = 0.046). Based on these results, the study recommended that efforts to raise awareness of women in terms of health education and improving their socio economic conditions should be continued and strengthened. There is also need for continued efforts to improve coverage of health facilities in the rural areas. Capacity of health services should be strengthened both in terms of skilled health attendants and medical supplies