Predictors of Postnatal Care Utilization among Postnatal Mothers: A Community-based Cross-sectional Study in Northern Ghana

Abstract

Introduction: Postnatal care (PNC) is crucial for both mothers and newborns, reducing maternal and neonatal fatalities. It is essential for mitigating physical and cognitive impairments, disability, and mortality. However, it is often underutilized for delivering high-quality services. Most maternal and newborn fatalities occur during the first month postpartum, with complications more likely in-home deliveries. The global decline in infant mortality is slower than in under-five mortality. The study aims to assess the predictors of postnatal care services among postnatal mothers in Northern Ghana. Methods: The study used a community-based cross-sectionalresponsesa community-based   cross-sectional study design in Tamale Metropolis. It recruited 326 postnatal mothers who were willing to participate. The sample units were recruited using disproportionate stratified                     sampling. A structured questionnaire was used to solicit the participants' responses. Data was analyzed using Stata version 18, and a p value less than 0.05 was considered statistically significant. Results: A majority, 58.9%, are under 30 years old, 77% are married, employment status shows \50.9% are unemployed. Regarding reproductive history, 62.3% have been pregnant fewer than four times, while 37.7% have had four or more pregnancies. In terms of distance to healthcare, 50.3% live less than 6 kilometers from a health facility, the majority, 78.2%, can reach a health facility in 1 hour or less, while 21.8% take more than an hour. All respondents (100%) have heard of postnatal care. The main source of information about PNC is health workers (66%), followed by community meetings (16.6%), radio/TV (9.8%), and family and friends (7.7%). Regarding the recommended number of PNC visits, 58.6% believe that mothers and babies should visit four or more times. The data shows that 92.9% of mothers attended postnatal care (PNC) within 48 hours, with 54.0% attending 2-3 times within the first 42 days. The main reasons for attending were immunization for the baby (91.7%), monitoring the baby’s health (88.7%), and monitoring the mother's health (53.7%). The analysis revealed several significant associations between postnatal care utilisation and age (p = 0.041), marital status (p = 0.037), and the highest level of education completed (p = 0.009), gravida (p = 0.001), parity (p = 0.003), distance to the health center (p = 0.049) and average time to reach the health center (p = 0.009). Conclusion: The research indicates a positive attitude towards postnatal care among mothers, but challenges like budget and logistical issues need to be addressed. To improve access, engagement, and health outcomes, a multimodal strategy involving technology, community participation, and healthcare system enhancements is recommended.