Abstract:
Background: Recent information suggested that most maternal and infant death occur in the first month after birth and 66% occur during the first week. Skill birth attendant and early postnatal care (PNC) are the strategies to reduce preventable maternal and newborn. However, it is only 17% of women and 13% of newborn receive PNC checkup within 48 hours. Postnatal care reaches even fewer women and newborn. PNC service with 48 hours is lower institutional delivery (26%) in Ethiopia. There is limited evidences on the reasons of low utilization of PNC services in Ethiopia.
Objective: To explore the reasons for low utilization of early postnatal care services in East Wollega Zone, Oromia.
Method: An exploratory qualitative study was conducted using in-depth interview guide in East Wollega Zone, Oromia Region, Ethiopia. The interviews were conducted at Health Centers. The respondents were women who give birth before 6wks and came for EPI service to health facility. Altogether 20 interviews analyzed using thematic analysis.
Result: The main reasons for low utilization of early PNC service in East Wollega were perceived healthy, traditional beliefs (evil attack, draft, and divine protection) and postnatal rituals, reduced risk of vulnerability to postnatal complications, lack of awareness on benefits of early PNC services and low self-efficacy among postnatal women. Lack of support and family influence on decision making, poor counseling, and providers overlooked early PNC appointment or missed to link with HEWs for follow up visit. Birth notification affect postnatal women from getting service in the first week after child birth was lacking
Conclusion and Recommendation: Individual, social and health system factors are affecting women in East Wollega zone from getting early PNC. Counseling to pregnant women and their families on the importance of early PNC and 24 hours postnatal health facility stay as part of the child birth plan preparedness. Health provider should help the families of pregnant women to identify someone to immediately notify labor and/or child birth in case of home delivery. Improve referral linkage between health facilities and health posts to ensure early postnatal home visit provided by HEWs. Regular review PNC service provision and referral linkage during monthly primary Health Care performance review will improve service delivery.
......................................... Thesis available at ACIPH Library