Home            Contact us            FAQs
    
      Journal Home      |      Aim & Scope     |     Author(s) Information      |      Editorial Board      |      MSP Download Statistics

     Current Research Journal of Social Sciences


Utilization of Maternal Postnatal Care Services Among Women in Selected Villages of Bahi District, Tanzania

James Lwelamira, John Safari and Angelina Stephen
Department of Population Studies, Institute of Rural Development Planning, P.O. Box 138, Dodoma, Tanzania
Current Research Journal of Social Sciences  2015  4:106-111
http://dx.doi.org/10.19026/crjss.7.1690  |  © The Author(s) 2015
Received: March ‎19, ‎2015  |  Accepted: March ‎24, ‎2015  |  Published: October 25, 2015

Abstract

Tanzania is among the countries in sub-Saharan Africa with high rate of maternal mortality. Postpartum deaths caused by obstetric factors occur mainly due to limited access and use of maternal health care services. A cross-sectional study was conducted in July, 2014 in Bahi district, Central Tanzania. The objective of the study was to assess the utilization maternal postnatal care (PNC) services and determinants for its utilization. The study involved a random sample of 134 women whose last live child birth occurred within two years preceding the survey. Key issues investigated were awareness to maternal PNC services on health facilities and attitude on the services; timing and frequency of use of maternal PNC services and barriers for utilization of the services. Results show that majority of women (94.8%) were aware of the existence of maternal PNC services in health facilities. Nearly 82% of women had positive attitude towards maternal PNC services. However, only 71.6% of them used the services in their most recent child birth, 70.8% had one to two PNC visits for checkup within 42 days post delivery as opposed to the recommended three visits; and only 41.7, 45.6 and 32.1%, respectively of women that had first, second and third maternal PNC visits, attended the visits timely. Factors associated with non- use of maternal PNC services included low education level, long distance to health facilities, low household income, non-attendance to health facilities for antenatal care service, home delivery, negative attitude towards maternal PNC services and negative perception on quality of maternity health services in health facilities. Women with at least secondary education were more likely to use maternal PNC services compared to those with no formal education (OR = 1.40, p = 0.020). Likewise, women from high income families were more likely to use the services compared to the counterpart (OR = 1.67 p = 0.015). On the other hand, women living in distant areas from health facility i.e., more than 5 km from homestead, were less likely to use the services compared to the counterpart (OR = 0.75, p = 0.033). Non-use of antenatal care services (ANC) also decreased odds for use of maternal PNC services among women (OR = 0.68, p = 0.017). Results further indicate women delivered in health facilities were more likely to report use of maternal PNC services compared to those delivered at home (OR = 2.03, p = 0.004) and women who attached less importance to maternal PNC services were 58% less likely to use the services compared to the counterpart (OR = 0.42, p = 0.003), while those think that quality of maternity health services in health facilities are good were 40% more likely to use maternal PNC services compared to the counterpart (OR = 1.40, p = 0.046). Based on these results, the study recommended that efforts to raise awareness of women in terms of health education and improving their socio-economic conditions should be continued and strengthened. There is also need for continued efforts to improve coverage of health facilities in the rural areas. Capacity of health services should be strengthened both in terms of skilled health attendants and medical supplies.

Keywords:

Determinants, health care, mothers, rural areas,


References

  1. Ahmed, S., A.A. Creanga, D.G. Gillespie and A.O. Tsui, 2010. Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PloS One, 5(6): e11190.
    CrossRef    PMid:20585646 PMCid:PMC2890410    
  2. Akunga, D., D. Menya and M. Kabue, 2014. Determinants of postnatal care use in Kenya. Afr. Populat. Stud., 28(3): 1447-1459.
    CrossRef    
  3. Babalola, S. and A. Fatusi, 2009. Determinants of use of maternal health services in Nigeria-looking beyond individual and household factors. BMC Preg. Childbirth, 9(1): 43.
    CrossRef    PMid:19754941 PMCid:PMC2754433    
  4. Bulatao, R.A. and J.A. Ross, 2003. Which health services reduce maternal mortality? Evidence from ratings of maternal health services. Trop. Med. Int. Health, 8(8): 710-721.
    CrossRef    PMid:12869092    
  5. Dieleman, J.L., C.M. Graves, T. Templin, E. Johnson, R. Baral, K. Leach-Kemon and C.J. Murray, 2014. Global health development assistance remained steady in 2013 but did not align with recipients' disease burden. Health Affair., 33(5): 878-886.
    CrossRef    PMid:24714869    
  6. Ejaz, S. and K. Ahmad, 2013. Postpartum care utilization among primigravida: A study in rural Punjab, Pakistan. Res. Human. Soc. Sci., 3(4).
  7. Eliakimu, E.S., 2010. Assessment of maternal postnatal care utilization and associated factors among women with infants aged 2 -6 months in Shinyanga Rural District, Shinyanga Region. M.A. Thesis, Department of Public Health, Muhimbili University of Health and Allied Sciences, pp: 78.
  8. Filippi, V., C. Ronsmans, O.M. Campbell, W.J. Graham, A. Mills, J. Borghi and D. Osrin, 2006. Maternal health in poor countries: The broader context and a call for action. Lancet, 368(9546): 1535-1541.
    CrossRef    
  9. Fisher, A.A., J.E. Laing and J.W. Townsend, 1991. Handbook for family planning operations research and design. Operations Research, Population Council, USA.
  10. Gage, A.J., 2007. Barriers to the utilization of maternal health care in rural Mali. Soc. Sci. Med., 65(8): 1666-1682.
    CrossRef    PMid:17643685    
  11. Goodburn, E. and O. Campbell, 2001. Reducing maternal mortality in the developing world: sector-wide approaches may be the key. Brit. Med. J., 322(7291): 917.
    CrossRef    PMid:11302911 PMCid:PMC1120077    
  12. Kabakian-Khasholian, T. and O.M. Campbell, 2005. A simple way to increase service use: triggers of women's uptake of postpartum services. Int. J. Gynaecol. Obstet., 112(9): 1315-1321.
    CrossRef    PMid:16101614 PMCid:PMC1457107    
  13. Kalule-Sabiti, I., Y.A. Amoateng and M. Ngake, 2014. The effect of socio-demographic factors on the utilization of maternal health care services in Uganda. Afr. Populat. Stud., 28(1): 515-525.
    CrossRef    
  14. Khan, K.S., D. Wojdyla, L. Say, A.M. Gülmezoglu and P.F. Van Look, 2006. WHO analysis of causes of maternal death: A systematic review. Lancet, 367(9516): 1066-1074.
    CrossRef    
  15. Kinney, M.V., K.J. Kerber, R.E. Black, B. Cohen, F. Nkrumah, H. Coovadia and J.E. Lawn, 2010. Sub-Saharan Africa's mothers, newborns and children: Where and why do they die? PLoS Med., 7(6): e1000294.
    CrossRef    PMid:20574524 PMCid:PMC2888581    
  16. Kisinza, W.N., A. Talbert, P. Mutalemwa and H. Mccall, 2008. Community knowledge, attitudes and practices related to tick-borne relapsing fever in Dodoma rural District, Central Tanzania. Tanzania J. Health Res., 10(3): 131-136.
    CrossRef    PMid:19024337    
  17. Kiwanuka, S., E. Ekirapa, S. Peterson, O. Okui, M.H. Rahman, D. Peters and G. Pariyo, 2008. Access to and utilisation of health services for the poor in Uganda: A systematic review of available evidence. T. Roy. Soc. Trop. Med. H., 102(11): 1067-1074.
    CrossRef    PMid:18565559    
  18. Kruk, M.E., P.C. Rockers, G. Mbaruku, M.M. Paczkowski and S. Galea, 2010. Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis. Health Policy, 97(2-3): 209-216.
    CrossRef    PMid:20537423    
  19. Li, X., J. Fortney, M. Kotelchuck and L. Glover, 1996. The postpartum period: the key to maternal mortality. Int. J. Gynecol. Obstet., 54(1): 1-10.
    CrossRef    
  20. Matsumura, M. and B. Gubhaju, 2001. Women's status, household structure and the utilization of maternal health services in Nepal: Even primary-leve1 education can significantly increase the chances of a woman using maternal health care from a modem health facility. Asia Pac. Populat. J., 16(1): 23-44.
  21. Mmbaga, V.M., 2003. Utilization of health services by mothers of infants during their post partum period in Temeke Municipal, Dar es salaam Tanzania. M.A. Thesis, Department of Public Health, Muhimbili University of Health and Allied Sciences, pp: 71.
  22. Mpembeni, R.N.M., J.Z. Killewo, M.T. Leshabari, S.N. Massawe, A. Jahn, D. Mushi and H. Mwakipa, 2007. Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: Implications for achievement of MDG-5 targets. BMC Preg. Childbirth, 7: 29.
    CrossRef    PMid:18053268 PMCid:PMC2222241    
  23. Ndunguru, E., 2007. Assessment of utilization of maternal health services and associated factors for women with infants in rural Morogoro district council. M.A. Thesis, Department of Public Health, Muhimbili University of Health and Allied Sciences, pp: 62.
  24. Olsen, B.E., S.G. Hinderaker, M. Kazaura, R.T. Lie, P. Bergsjo, P. Gasheka and G. Kvale, 2000. Estimates of maternal mortality by the sisterhood method in rural northern Tanzania: A household sample and an antenatal clinic sample. BJOG, 107(10): 1290-1297.
    CrossRef    PMid:11028583    
  25. Parkhurst, J.O., L. Penn-Kekana, D. Blaauw, D. Balabanova, K. Danishevski, S.A. Rahman and F. Ssengooba, 2005. Health systems factors influencing maternal health services: A four-country comparison. Health Policy, 73(2): 127-138.
    CrossRef    PMid:15978956    
  26. Ronsmans, C. and W.J. Graham, 2006. Maternal mortality: Who, when, where and why? Lancet, 368(9542).
    CrossRef    
  27. Rosenfield, A., C.J. Min and L.P. Freedman, 2007. Making motherhood safe in developing countries. New Engl. J. Med., 356(14): 1395-1397.
    CrossRef    PMid:17409320    
  28. Smith, K.V. and S. Sulzbach, 2008. Community-based health insurance and access to maternal health services: Evidence from three West African countries. Soc. Sci. Med., 66(12): 2460-2473.
    CrossRef    PMid:18362047    
  29. Tsegay, Y., T. Gebrehiwot, I. Goicolea, K. Edin, H. Lemma and M.S. Sebastian, 2013. Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: A cross-sectional study. Int. J. Equity Health, 12(30): 1475-9276.
    CrossRef    
  30. URT, 2008. Bahi District Socio- Economic Profile. United Republic of Tanzania. pp: 123.
  31. URT (United Republic of Tanzania), 2010. Tanzania demographic and health survey. Preliminary Report, National Bureau of Statistics, United Republic of Tanzania, Measure ICF Macro, USA.
  32. Wang, W., S. Alva, S. Wang and A. Fort, 2011. Levels and trends in the use of maternal health services in developing countries. DHS Comparative Reports No. 26, ICF Macro, Calverton, Maryland, USA.
  33. WHO, 1998. Postpartum care of the mother and newborn: A practical guide WHO/RHT/MSM/983, Geneva.
  34. WHO, 2004. Maternal mortality in 2000: Estimates developed by WHO, UNICEF and UNFPA. World Health Organization, Geneva.
  35. Woldemicael, G., 2010. Do women with higher autonomy seek more maternal health care? Evidence from Eritrea and Ethiopia. Health Care Women Int., 31(7): 599-620.
    CrossRef    PMid:20526926    
  36. Yakong, V.N., K.L. Rush, J. Bassett-Smith, J.L. Bottorff and C. Robinson, 2010. Women's experiences of seeking reproductive health care in rural Ghana: Challenges for maternal health service utilization. J. Adv. Nurs., 66(11): 2431-2441.
    CrossRef    PMid:20735507    
  37. Zere, E., J.M. Kirigia, S. Duale and J. Akazili, 2012. Inequities in maternal and child health outcomes and interventions in Ghana. BMC Public Health, 12(1): 252.
    CrossRef    PMid:22463465 PMCid:PMC3338377    

Competing interests

The authors have no competing interests.

Open Access Policy

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Copyright

The authors have no competing interests.

ISSN (Online):  2041-3246
ISSN (Print):   2041-3238
Submit Manuscript
   Information
   Sales & Services
Home   |  Contact us   |  About us   |  Privacy Policy
Copyright © 2024. MAXWELL Scientific Publication Corp., All rights reserved