Abstract:
Objective Postnatal care (PNC) is essential for preventing
maternal and newborn deaths; however, it still remains
less well recognised in low-income and middle-income
countries. This study was aimed to explore geographical
patterns and identify the determinants of PNC usage
among women aged 15–49 years in Ethiopia.
Methods A secondary data analysis was conducted using
the 2016 Ethiopian demographic and health survey data.
A total of 7193 women were included in this analysis.
We employed spatial scan statistics to detect spatial
inequalities of PNC usage among women. A multilevel
binary logistic regression model was fitted to identify
factors associated with women’s PNC.
Results The prevalence of PNC usage among women
was 6.9% (95% CI 6.3% to 7.5%). The SaTScan spatial
analysis identified three most likely clusters with low rates
of PNC use namely southwestern Ethiopia (log likelihood
ratio (LLR)=18.07, p<0.0001), southeast Ethiopia
(LLR=14.29, p<0.001) and eastern Ethiopia (LLR=10.18,
p=0.024). Women with no education (Adjusted Odd Ratio
(AOR)=0.55, 95% CI 0.37 to 0.84) and in the poorest
wealth quantile (AOR=0.55, 95% CI 0.39 to 0.78) were less
likely to use PNC, while women aged 35–49 years (AOR:
1.75, 95% CI 1.01 to 3.04) and with at least four antenatal
care (ANC) visits (AOR=2.37, 95% CI 1.71 to 3.29) were
more likely to use PNC.
Conclusion PNC usage remains a public health problem
and has spatial variations at regional levels in the country.
Low prevalence of PNC was detected in the Somali,
Oromia, Gambella and Southern Nations, Nationalities,
and People's Region (SNNPR) regions. Women with low
educational status, old age, being in poorest wealth
quantile and history of ANC visits were significantly
associated with PNC usage. Hence, it is better to
strengthen maternal health programmes that give special
emphasis on health promotion with a continuum of care
during pregnancy.
