Appreciating the Essence of Post Natal Care Services from Mothers’ Perspective in Kiambu, Kenya

Abstract

Introduction: The first 42 days after delivery is a critical period in the lives of mothers and newborn babies.  Most maternal and infant deaths occur during this time. The   government of Kenya has recommended that all mothers and newborns receive three postnatal (PNC) checkups this period. These are; within 48 hours before discharge from post-natal ward, at 2 weeks and again at 6 weeks. Nonetheless, uptake of postnatal services particularly visit two remains low. For instance 25% of mothers in Kiambaa Sub County access PNC at two weeks. Study Design: A cross sectional descriptive study design was conducted among 399 mothers to determine the factors that influence utilization of PNC services. Study Area and duration: This research was undertaken in Kiamba, Kiambu County between August and September, 2013. Methodology: This was a mixed qualitative and quantitative study. Simple random sampling was used to select participating administrative units and respondents selected systematically. Sample size distribution was by probability proportionate to size. Quantitative data was analyzed using Stata version 13, while qualitative data was analyzed manually based on themes. Results: Utilization of PNC services was at 45.1%. Over half (53%) of the respondents made their first PNC post-delivery visit after 14 days, 11% and 36% within 7 and 14 days respectively. The health care workers had informed only 15 % of the women, to attend the PNC services. College education (OR=12.292, p<0.001); high household wealth status (OR=3.6211, p<0.001); formal employment (OR=2.705, p=0.008); delivery at a private facility (OR=2.9269, p< 0.000) and high knowledge of PNC services (OR=2.2307, p=0.008) were synonymous with utilization of PNC services. Perceived good quality of care (OR=5.2607, p< 0.000), and a positive attitude (OR=3.6507, <0.000) were other determinants. Conclusion: Uptake of postnatal care services remains a challenge among mothers and is predicted by several overt and covert constraints. Quality of delivery services and providers respective care practices were key predictors. Nevertheless, close to half of the women sought postnatal care at least twice in the post-natal period. The services were mainly accessed at or after 6 weeks. The timing of first PNC, post- delivery visit varies. Uptake of PNC visit two remains low.