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Factors Affecting Access to Early Postnatal Care Service among Women of Urban Slum in Bangladesh

Factors Affecting Access to Early Postnatal Care Service among Women of Urban Slum in Bangladesh
Mohammad Ashraful Hasan
Issue Date
Background: The postnatal period, the hours and days after birth is critical to the health for survival and is the most vulnerable time for a mother and newborn. Majority of maternal death occur after delivery but the postnatal period is the most ignored time for the establishment of quality services yet now in Bangladesh. Therefore, this study made an attempt to assess the impact of the challenges to access in early postnatal care (PNC) in improving the women and newborn health situation in Bangladesh. Methods: A quantitative research involving community based cross sectional descriptive study was conducted among women reproductive age group (of 18-49 years) who gave birth in the last one year prior to the study in different slums of Dhaka south city corporation, Dhaka, the capital city of Bangladesh from September to October 2016. A stratified sampling method was employed to select the total of 389 study participants. Data were collected by means of a pretested structured interviewer administered questionnaire. Chi square and binary logistic regression analysis was carried out by using SPSS version 21. Results: Findings revealed that, 29.1% women and 29.8% of their baby received PNC visit after last delivery. The factors that significantly affected access to PNC utilization in this study were women’s education (p Value: <0.001
OR: 0.254
95% CI: 0.129-0.498), household income (p Value: <0.001
OR: 0.036
95% CI: 0.014-0.095), residence (p Value: <0.001
OR: 10.43
95% CI: 3.378-32.201), husband’s education (p Value: <0.001
OR: 0.113
95% CI: 0.063-0.203) and occupation (p Value: <0.001
OR: 0.069
95% CI: 0.041-0.118), physical violence against women (p Value: <0.001
OR: 0.063
95% CI: 0.037-0.108), place of delivery (p Value: <0.001
OR: 0.151
95% CI: 0.093-0.245), ANC visit (p Value: <0.001
OR: 6.799
95% CI: 4.093-11.294), PNC checkup for baby (p Value: <0.001
OR: 304.3
95% CI: 119.0-778.16), postnatal complications (p Value: <0.001
OR: 4.503
95% CI: 2.706-7.493), importance of PNC checkup (p Value: <0.001
OR: 52.95
95% CI: 24.28-115.46), knowledge in PNC service (p Value: <0.001
OR: 0.066
95% CI: 0.038-0.117), perception of postnatal danger sign (p Value: <0.001
OR: 0.214
95% CI: 0.119-0.382), sources (more than one) of information (p Value: <0.001
OR: 0.019
95% CI: 0.010-0.037), transport use (p Value: <0.001
OR: 0.600
95% CI: 0.371-0.971), and health insurance (p Value: <0.001
OR: 21.01
95% CI: 4.719-93.593). Conclusion: Access to PNC utilization was low in the study area. Education, household income, husband’s education and occupation, physical violence, place of delivery, ANC visit, knowledge on PNC components, awareness in postnatal danger signs, and health insurance were found to be the important predictors of PNC utilization. Among those, domestic physical violence against women and health insurance emerged as strong predictors. Therefore, there is a crucial need for public health interventions to increase the access rate to early postnatal care service that should target women who need this service at the appropriate time. Keywords: Access, Early postnatal care, Women, Urban slum, Bangladesh
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