Abstract:

Background: Postpartum care is vital for the mother and newborn. Studies indicate that majority of maternal and neonatal deaths happen during the postpartum period. However, on the continuum care, the utilization of postpartum care in low and middle income countries (LIMC) is limited. Improving postpartum care attendance among post-delivery women is expected to improve the survival of the mother and newborn. The aim of this study was to identify individual, community and health facility factors associated with postpartum care attendance among post-delivery women in rural Geita district.

Methods: This study used a cross sectional design. Systematic sampling method was used to recruit 269 postnatal women at reproductive and child health clinics (RCH) from ten different health facilities in Geita district. A semi-structured interview questionnaire was administered to obtain information on utilization of postpartum care and associated factors. Bivariate and logistic regression model were used to find the statistical significant association between utilization of postpartum care and explanatory variables.

Results: Prevalence of utilization of postpartum care for the recommended minimum three visits was low (17.0%) compared to that observed in the Tanzania demographic and Health Survey of 2010 which was 31%. It was observed that majority (61%) of the post-delivery women attend at least a single visit for postpartum care. Women husband education level such that (primary level AOR 3.16, 95%CI 1.34-7.47, p=0.009, secondary/college level AOR 5.52, 95%CI 1.30-23.40, p=0.020) and women birth planning (AOR 2.30, 95%CI 1.40-3.90, p=0.001) were the individual factors associated with postpartum care attendance. However maternal education this study was not associated with postpartum care attendance. In terms of health facility factors; place of delivery (AOR 6.12, 95%CI 3.47-10.8, p<0.0001), place where women attend for postpartum care (AOR 47.4 95%CI 6.30-356.6, p<0.001) and maternal ANC attendance (AOR 40.9 95%CI 5.2-317.0, p<0.001) were strongly significant associated with postpartum care attendance. In addition community awareness to postpartum care attendance (AOR 39.7 95%CI 15.0-104.5, p<0.001), and knowledge of the minimum number of recommended visit (AOR 3.69 95%CI 1.56-8.76, p=0.003) were also strongly significant associated with postpartum care attendance. Implying that post-delivery women with awareness and knowledge to number of postpartum visits were the one with high likelihood of attending for postpartum care.

Conclusion: This Study highlighted the poor utilization of postpartum care among post-delivery women for women making a recommended minimum of three visits who live in rural Geita district. Women husband’s level of education, birth planning, maternal ANC attendance, place of were the factors associated with utilization of postpartum care. In addition knowledge on the minimum recommended number of postpartum visits showed positive effect on postpartum care attendance among post-delivery women. Thus in improving postpartum care attendance, maternal and child health intervention should be made on those factors as well as emphasis on male involvement in postpartum care.