Date of Award

11-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Shiyam Sundar

Second Advisor

Dr. Sarah Saleem

Third Advisor

Ms. Fauzia Hasnani

Department

Community Health Sciences

Abstract

Background: Every year approximately 289,00 maternal deaths and around 2.4 million newborns die in the first 28 days of life globally, most of these neonatal deaths occur at home, and around more than half of maternal deaths are due to labor pain, delivery, and the immediate postpartum period. Pakistan is one of the countries in South Asia ranking high in Maternal mortality rate, the maternal mortality ratio in Pakistan is 186/100,000 live births, and the ratio is nearly 26% higher in rural areas as compared to urban areas majority of maternal deaths around 75% occur in the postnatal period caused by complication like Hemorrhage, sepsis, Eclampsia. Postnatal Care (PNC) is the least utilized component in Pakistan around 38% of women received PNC and the remaining women never had any Postnatal checkups and didn’t give them importance. Therefore, PNC is desperately needed in healthcare to save the life of mothers and newborns. Despite all improvements, maternal mortality ratio and neonatal mortality and safe motherhood intervention stay challenging in achieving the SDG in Pakistan, so this study is to understand the determinants of Postnatal health care seeking.
Methods: This was a community-based cross-sectional study. A sample of (n=822) participants who delivered a baby in the last two years was recruited from catchment areas of Global Network’s Maternal and Newborn Health Registry, Thatta. Using a consecutive sampling technique, the study was conducted from June to September 2022. A pre-tested structured questionnaire was used for data collection. The data was analyzed on Software Stata version 17.0 using the Cox proportional algorithm
Results: The mean age of participants was 27 (±10.1). The study finds that (34 %) of women received PNC. (57.6 %) went to a government health facility. According to the health service providers, 65 % of women did not have any consultation with the healthcare provider to seek PNC. Multivariable regression analysis showed that the factors associated with no utilization of PNC include physical accessibility to health facility (PR= 1.01, 95%CI= 0.840 - 1.22), Discharge time after delivery mothers who delivered at home (PR= 11.36, 95% CI= 5.56 - 23.20) mothers who discharge within 24 hours after delivery (PR= 10.25, 95% CI= 5.24 – 20.07), the mother have no any antenatal visit (PR= 1.22, 95% CI= 1.00 – 1.60), the mother who got 1 to 3 Antenatal visits (PR= 1.29, 95% CI= 1.02 – 1.64), women who didn’t hear anything about PNC (PR= 1.32, 95% CI=1.08 – 1.61), mothers who have 3-5 children (PR= 1.19, 95% CI=1.00 – 1.58), mothers who have more than 5 children (PR=1.24, 95% CI= 1.00 – 1.56).
Conclusion: Our study that the prevalence of not utilization of PNC is associated with the discharge time after delivery, especially for women who delivered at home, low utilization of antenatal care, mothers who didn’t hear anything about PNC, and parity of women. Furthermore, more services provision and awareness campaigns on the importance of PNC must be conducted to inform less aware inhabitants and provide services in rural areas to reduce maternal and newborn mortality rates.

First Page

1

Last Page

43

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