| dc.description.abstract | Background:
Postpartum period is a very special phase in the life of a woman and her newborn. For women experiencing childbirth for the first time, it marks probably the most significant and life-changing event they have yet lived. Despite the fact that around forty five percentage of maternal deaths occur within the first 24 hours after childbirth, and over sixty five percentage of maternal deaths occur during the first week of the postpartum period, health care providers continue to advise on a first check up at 6 weeks after childbirth.
Objective:
The main objective of this study was to assess utilisation of postnatal care services among women aged 15-49 years in Juba County- South Sudan and the specific objectives were; to determine the level of awareness of women about PNC services among women aged 15-49 years in Juba county; to determine the socio cultural factors that influence utilisation of PNC services among women aged 15-49years in Juba county; to establish human resource factors that influence utilization of PNC services among women aged 15-49years in Juba county; to determine the health facility management factors that influence utilisation of the PNC services among women aged 15-49years in Juba county.
Methodology:
The study adopted a descriptive cross sectional study design in order to give detailed description of the factors included within the specific objectives. The study population was all women aged 15 – 49 years who had delivered within a period of ten (10) weeks prior to carrying out the study in Juba County. A stratified random sampling technique was adopted to select the sample needed for the study. Simple random sampling was used to sample the Payams in the county; households were then sampled in each Payam using stratified sampling. The final sample units that met the selection criteria were picked from the households.
Results:
Less than half of the respondents 48 (37%) were aware about post natal care services and all its components. Socio-cultural factors had a strong statistical significant influence on utilisation of PNC services (p = 0.000). The socio cultural factors which were significantly related to utilisation of PNC included the cultural belief that traditional medicine can be used in PNC (P=0.000), cultural beliefs not allowing women to go to hospital for delivery (p=0.000), prohibition of any physical activity after birth; precautions for infant care in the respondents culture; the infant should not be touched on the head after birth; observation of a period of confinement after birth, during which women rest; the belief that childbirth is considered a natural event and is usually drug-free, and isolation of labouring women due to birth-related pollution beliefs. Significant human resource factors included number of health workers (p=0.000), attitude of health worker; and use of words of encouragement. Management factors
which were found to be predictors of utilisation of PNC services were time taken to access the services (p=0.000), satisfaction with PNC services provided (p=0.000), provision of free services (p=0.019), having no government health facilities in the area (p=0.021) and whether hospital management listened and responded to patient complaints in a timely manner (p=0.000).
Conclusion:
The level of utilisation of Post Natal Care Services is still low in Juba County and it has been established that socio-cultural factors, human resource and health facility management factors are related to this low utilisation. Great effort is still needed by government to improve on the level of PNC utilisation especially in demystifying the cultural myths surrounding postpartum care.
Recommendations:
The county health teams under Ministry of Health should conduct outreach services for PNC and to build more health centers so that (PNC) services are brought closer to the mothers in every area of Juba County especially for the mothers who stay far from health centers to travel as they may not have bus fare and too weak to travel. The Health Promotion Officers should provide PNC learning aids and health education to the pregnant mothers and those who just delivered in the communities so that the women may know more about PNC. | en_US |
