Socio Demographic Characteristic
The total eligible sample size of 420 participated in the study which yielded a response rate about 100%. The age of the participants ranged from 14–39 years with mean age of 27.4 (SD = 4.5) years and 385(91.7%) of respondents were married. Regarding the religion of the respondents, 203(48.3%) were Muslims followed by orthodox 137(32.6%). Regarding to ethnicity 189(45%) were Oromos and followed by Amhara 63(15%). Almost half of respondent’s monthly income was greater than two thousand five hundred 207(49.3%) (Table 1) at end of the document.
Table 1
Socio-demographic characteristics of respondents (n = 420)
Variables | Frequency | Percentage |
Age Category | 15–19 | 20 | 4.7 |
20–24 | 111 | 26.4 |
25–29 | 152 | 36.1 |
30–34 | 101 | 24.3 |
35+ | 36 | 8.6 |
Marital status | married | 386 | 91.7 |
single | 15 | 3.6 |
Widowed | 11 | 2.9 |
Divorced | 8 | 1.9 |
Religion | Protestant | 64 | 15.2 |
Orthodox | 137 | 32.6 |
Muslim | 203 | 48.3 |
Catholic | 16 | 3.8 |
Ethnicity | Oromo | 189 | 45 |
Amhara | 63 | 15 |
Siltie | 47 | 11.2 |
Tigray | 47 | 11.2 |
Yam | 45 | 10.7 |
Kafa | 20 | 4.8 |
Dawuro | 9 | 2.1 |
Educational status of mother | unable to read and write | 45 | 10.7 |
primary school | 123 | 29.3 |
high school | 145 | 34.5 |
college and above | 107 | 25.4 |
Income | < 1000 | 53 | 12.6 |
1001–1500 | 41 | 9.7 |
1501–2000 | 92 | 22 |
2001–2500 | 27 | 6.4 |
| > 2500 | 207 | 49.3 |
Parity | 1 | 169 | 40.2 |
2–4 | 241 | 57.4 |
5+ | 10 | 2.4 |
Educational status of husbands | Unable to read and write | 62 | 14.8 |
primary school | 121 | 29.5 |
High school | 195 | 46.4 |
College and above | 42 | 10 |
Occupation of mother | House wife | 132 | 31.4 |
Merchant | 75 | 17.8 |
Day laborer | 62 | 14.8 |
Civil Servant | 83 | 19.8 |
Private employee | 51 | 12.4 |
Student | 17 | 4.0 |
Regarding obstetric history
241 (57%) of respondents were Para two - four and 169 (40.2%) are prim Para. Three hundred twenty nine (78.3%) of respondents gave birth vaginally.
Concerning ANC follow-up and place of delivery: - From total respondents, 333 (79.2%) have ANC follow up. From this 190 (57%) and 122 (37%) respondents were having follow up at health center and hospital respectively. The rest of respondents, 21(6%) followed ANC at non-government institutions. During ANC follow up 327(98%) were counseled to give birth at health institution.
Regarding place of delivery, 194(48%) and 182(41.2%) mothers gave birth at hospital and Health center respectively. Home, non-governmental institutions, and health post deliveries accounted for 23 (5.5%), 20(4.8%) and 1(0.2%) respectively. From all institutional deliveries, 323 (81.3%) where counseled to attend PNC.
Access and Availability of PNC service: - Most of respondents were using public transport to go health facilities, and half of respondents’ reported that it takes 30 minute- 1 hr. to reach to health facility (Table 2).
Table 2
Access and Availability of PNC service for respondents (n = 420)
Variable | | Frequency | Percentage |
Means of transport usually use to go to the health facility | On foot/walk | 74 | 17.6 |
Public transport | 339 | 80.7 |
Ambulance | 1 | 0.2 |
Horse/Gray | 6 | 1.4 |
Distance from residence to health care facility | Less than 30 minutes | 210 | 50% |
30 min-1hr | 210 | 50% |
Respect from health care provider | No | 60 | 14.3 |
Yes | 360 | 85.7 |
Kept privacy with service providers | No | 64 | 15.2 |
Yes | 356 | 84.8 |
Feeling/personal views about the quality of health services in the health facility | bad | 99 | 23.6 |
good | 260 | 61.9 |
satisfactory | 61 | 14.5 |
Self-decision to go health facility at any time to follow PNC | No | 81 | 19.3 |
Yes | 339 | 80.7 |
Awareness of respondents on postnatal care
- Most of the respondents, 386 (91.9) knew about presence of postnatal care services at study area. About 283 (67.4%) and 315(75%) mothers knew maternal danger sign and symptoms come after giving birth and danger signs of the baby respectively (Table 3)
Table 3
Awareness of postnatal care services among respondents (n 420)
Variable | Frequency | percentage |
Awareness about availability of postnatal care services | 386 | 91.9 |
Awareness about presence of risk in post-natal period. | 376 | 87.4 |
Respondents who knew to go health facility for PNC | 333 | 79 |
When to go to health facility | First 24hrs | 50 | 15 |
As early as 48-72hrs of child birth | 37 | 11.2 |
7–14 days of child birth | 120 | 36 |
At 6 weeks of child birth | 98 | 29 |
After 6th week (after 42days) | 28 | 8 |
Awareness about maternal danger sign and symptoms | 283 | 67.4 |
Number danger signs of mother listed by respondents | 1 | 76 | 26.8 |
2 | 78 | 27.6 |
3 and above | 129 | 45.6 |
Awareness about danger signs of the baby | 315 | 75 |
Number of danger signs of baby listed by respondents | 1 2 3 and above | 7 68 240 | 2.2 21.6 76.2 |
Factors associated with postnatal care utilization.
Binary logistic regression analysis:
Binary logistic regression analysis was done to select candidate variables for multiple logistic regression analysis. From bivariate: age, family size, marital status, income, mother education, husband education, place of delivery, means of transport, ANC attendance, distance and self-decision, knowledge about danger signs mother which comes following delivery, and counseling to follow PNC, were candidates for multivariable logistic regression analysis
Multivariable logistic regression
From multivariable logistic regression analysis, knowledge about maternal danger signs which come after delivery, Family size, ANC follow up, educational status of the mother, counseling mother to follow PNC after delivery and distance from health facility were significantly associated with PNC utilization.
Those mothers who knew danger signs which comes after delivery were 11.5 times (AOR 11.5, 95% CI: 5.8, 22.7) more likely to utilize PNCs than mother were not aware of these post- partum complications. Similarly mothers who have ANC follow were 5.4 times (AOR = 5.4, 95% CI: 2.6, 11.3) more likely to utilized than who did not attend ANC during their last pregnancy.
Moreover ,women who were counseled to attend PNC during their last delivery were 14 times more likely to get postnatal care service than mothers who did not counseled ( AOR = 14, 95% CI :6.1, 31.4).Level of education is significantly associated with PNCS utilization, mothers who completed high school and college and above were 6.8 times and 11.7 more likely to utilize than mothers who were unable to read and write (AOR = 6.8, 95% CI: 2.2, 20.94, AOR = 11.7, 95% CI 3.5, 38.9) respectively.
Family size was significantly associated with postnatal care service utilization, for one person increment in family size, PNCS utilization increased nearly one times(β = 0.67). Those mothers who live close to health facility, that means distance which takes less than 30 minutes with available transport were 6.8 times more likely to utilized than those living far from health facility (AOR = 6.8, 95% CI 3.4, 13.6) (Table 4).
Table 4
significantly associated variables with PNC utilization (n = 420).
Variables in multiple logistic regression analysis | PNC utilization status | AOR | (95% CI) | p-value |
No | Yes |
Lower | Upper |
knowledge about maternal danger signs | NO | 91 | 46 | 1 | | | |
YES | 79 | 204 | 11.5 | 5.8 | 22.7 | .001* |
ANC follow up | No | 55 | 32 | 1 | | | |
Yes | 115 | 218 | 5.4 | 2.6 | 11.3 | .001* |
Counselling to attend PNC during delivery | NO | 80 | 17 | 1 | | | |
YES | 90 | 233 | 14 | 6.1 | 31.4 | 001* |
Educational status of the mother | Unable to read and read. | 31 | 14 | 1 | | | .001* |
primary school | 62 | 61 | 2.3 | .75 | 7.01 | .140 |
high school | 50 | 95 | 6.8 | 2.2 | 20.9 | .001* |
college and above | 27 | 80 | 11.6 | 3.5 | 38.8 | .001* |
Distance from health facility | Less than 30 minutes | 58 | 152 | 6.8 | 3.4 | 13.6 | 0.01* |
Greater than 30 minutes | 112 | 98 | 1 | | | . |
Family size | β = .669 | 1.9 | 1.5 | 2.5 | .001* |
AOR = 1 indicates reference group. |
* = significant at p- value less than 5% |
Hosmer and Lemeshow Test model adequacy p-value 0.46, overall percentage classification table is 82.2% and Nagelkerke R Square 60%. |