Determinants of Postpartum Care Utilization

Abstract

Background The postpartum period is considered a critical stage in pregnancy wherein majority of maternal deaths occur. Despite the decline in maternal deaths worldwide, the large disparities in maternal mortality ratio between developing and developed countries still reflect inequities in access to health services. Postpartum care services are important in enabling health workers to identify potential life-threatening complications after delivery and provide the necessary treatments immediately in order to prevent maternal deaths. However, this period is the most neglected phase in pregnancy and the utilization of postpartum care services is still low, especially among developing countries. Although national average levels of postpartum care visit to a skilled health worker has increased over the years, gaps still exist between different sociodemographic groups and geographic regions in the Philippines. Compared to prenatal and delivery care services, relatively little is still known regarding factors affecting postpartum care utilization, particularly in the Philippines.

Method This thesis examines the status of postpartum care utilization in a rural province in the Philippines and determines the factors affecting its uptake. Using a survey questionnaire, population characteristics such as sociodemographic, previous maternal health care use, and perception were investigated quantitatively for their influences on postpartum care utilization.

Results This study reveals several important factors, including age, skilled birth attendance, and perception on postpartum care.

Conclusion Although the Philippines has several policies in place related to maternal health, the importance of postpartum care has not been emphasized in these guidelines. The DOH recommendations regarding the timing and the number of postpartum care visits may need to be studied in light of the current WHO recommendations on postpartum care. A comprehensive postpartum care guideline for the country is also necessary and should include strategies to encourage women, especially those who are young and delivered by non-skilled workers, to receive postpartum care from skilled health workers. Community awareness programs regarding the importance of postpartum care can increase the utilization of these services and eventually reduce the gaps on maternal health outcomes.