Effectiveness of a Community Level Maternal Health Intervention in Improving Uptake of Postnatal Care in Migori County, Kenya

Abstract

Background: Provision of a continuum of care during pregnancy, delivery, and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Complications and lack of skilled postnatal care has negative consequences for mothers and babies. We examined to what extent a community level integrated maternal health intervention contributed to improvements in uptake of postnatal care.

Methods: An Ex post quasi-experimental design was applied. A population of 590 reproductive-aged women was used to assess the effectiveness of a community level integrated maternal health intervention, and to determine the predictors of uptake of postnatal care. Descriptive, bivariate and multivariate analyses were conducted.

Results: About three fifths (64%) of the women reported having sought postnatal care services at a healthcare facility within six (6) weeks. Women in the intervention group were 3.3 times more likely to uptake postnatal care at a healthcare facility (Adjusted Odds Ratio (AOR)= 3.31 [95% CI 1.245 to 8.804] p=0.016). Women referred to the healthcare facility for postnatal care by Community Health Workers (CHWs), were 2.72 times more likely to uptake the services (AOR= 2.72 [95% CI 1.05 to 7.07] p=0.039), than those not referred by CHWs. Distance to health facility 61% was identified as the major barrier, to uptake of postnatal care, while some mothers reported not feeling the need for postnatal care (11%).

Conclusion and Implications for Translation: Routine health education by trained providers at community level health facilities, coupled with enhanced CHWs' involvement can improve uptake of postnatal care. Ignorance and accessibility challenges were some of the identified barriers to the uptake of postnatal care.