Determinants of postnatal care non-utilization among women in Nigeria.

Oluwaseyi, Somefun Dolapo
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Although, there are several programs in place in Nigeria to ensure maternal and child health, maternal and neonatal mortality rates remain high with maternal mortality rates being 560/100,000 and neonatal mortality rates at 40/1,000 live births. While there are many studies on the utilization of maternal health services such as antenatal care and skilled delivery at birth, studies on postnatal care are rare. While efficient utilisation of postnatal care services has been proven to reduce morbidity and mortality among mothers and their newborns, the uptake of this service is low in Nigeria. Thus, identification of the factors that are associated with non-utilization of postnatal care services could shed light on what needs to be done to improve the uptake of the services in Nigeria and assist the country in achieving the MDG4 and MDG 5 targets of bringing down the levels of child and maternal mortality. Therefore, the aim of this study is to examine the factors associated with the non-utilization of postnatal care among mothers in Nigeria. Methods: Population-based cross-sectional data from 2008 Nigeria Demographic and Health Survey (NDHS) were used in this study. For analysis, the postnatal care uptake for 28,647 children born in the five years preceding the survey was considered. The dependent variable was a composite variable derived from a list of questions on postnatal care. Mothers who received postnatal care were coded as (0) while mothers who did not receive postnatal care were coded as (1). Child’s characteristics and mother's characteristics were used as the explanatory variables. Descriptive statistics were used to examine the patterns of postnatal care nonutilization by selected characteristics of mothers and children in the country. Binary logistic regression was used to identify factors associated with postnatal care non-utilization in Nigeria at bivariate and multivariate levels. Results: Results showed that 96% of the mothers of the 28,647 children did not utilize postnatal care services in the period examined. About 50% of the study population between 25-34 years did not utilize postnatal care and 46% of the women who did not utilize postnatal care had no education. Results from multivariate logistic regression show that accessibility, antenatal care use, birth size, education, place of delivery and region are significantly associated with the non-utilization of postnatal care services. Women who received antenatal care had lower odds (OR=0.23, 95% CI=1.09-1.87) of not utilizing postnatal care services. Also mothers of children who were smaller than average at birth had higher odds (OR=1.43, 95% CI=1.09- 1.87) of not utilizing postnatal care services. Conclusions: This study revealed the low uptake of postnatal care service in Nigeria. To increase mothers’ utilization of postnatal care services and improve maternal and child health in Nigeria, interventions should be targeted at mothers who deliver children that have low birth weight and great attention should be given to the women outside the South West region especially the Northern region of the country. In addition, it is crucial that steps should be taken on educating women. This would have a significant influence on their perceptions about the use of postnatal care services in Nigeria.
Postnatal care, Nigeria