Assessment of utilization of postpartum care services among women in Webuye West, Bungoma County, Kenya
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Date
2017-10
Authors
Otunga, Claire Luseno
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Abstract
Postpartum care is an important link in the continuum of care for maternal health. The postpartum period is critical because most maternal deaths occur during this time, yet this is the most neglected period for quality care provision. Postpartum Care (PPC) services are essential in the first six weeks extending to six months. When not offered they lead to complications, poor outcomes like morbidity and mortality. The aim of this study was to assess utilization and factors influencing utilization of PPC services among women in Webuye West, Bungoma County, Kenya. The study adopted a descriptive cross sectional design. The study population was all women of reproductive age with living children aged 6-9 months. Six Health Care Workers (HCWs) were key informants. The study composed of a sample of 384 women. The sampling techniques were purposive and simple random sampling. Data collection tools were a semi structured questionnaire, focus group discussions and interview guide. Data was analyzed using Statistical Package of Social Sciences (SPSS) version 20.Statistical analysis was done using Pearson‟s Chi-Square test.On proportion of women utilizing postpartum care services only 33.6% utilized in the required timings and the attendance of mandatory visits was less than 40% which was below the recommended. All the four PPC visits were statistically significant to utilization. On socio cultural factors majority 85.8% of the women reported staying indoors during this period. Majority 55.7% of them had cultural beliefs and practices performed, both being statistically significant to PPC utilization. Religious beliefs and practices too were dependent on use of PPC (X2 p<0.011).On knowledge factors majority 70.6% of the women first knew the services during ANC from HCWs, awareness of first and fourth visits were statistically significant to PPC service use .On health facility factors majority 74.8% of the women reported availability of the basic services and majority 75.9% of HCWs were friendly and helpful. These influenced service utilization. Majority 51.0% paid for services and waited for 31-60 minutes.HCWs availability, friendliness, waiting time and service charges were statistically significant (p < 0.005) thereby influencing PPC utilization .In conclusion the proportion of women utilizing PPC service was low. Utilization of PPC services being statistically significant and dependent on various factors including , staying indoors, religious beliefs and practices , knowledge during ANC , availability of HCW,waiting time, HCWs helpfulness and friendliness and service charge ( p < 0.005). The study therefore rejected the null hypothesis. The study recommends that there is need to increase more awareness on PPC service utilization by HCWs and community volunteers. Community involvement and collaboration of teams to mitigate socio cultural beliefs and practices. The County MOH and facility managers to implement policies on PPC and continuous capacity building that emphasize PPC service utilization and maternal, neonatal, child health (MNCH) integration
Description
A research thesis submitted in partial fulfillment of the requirements for the award of the degree of Master of Science in the school of Public Health of Kenyatta University. October 2017