Assessing postnatal care for newborns in Sub-Saharan Africa: A multinational analysis
Habitu Birhan Eshetu1, Fantu Mamo Aragaw2, Wubshet Debebe Negash3
1Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Insights
Postnatal care (PNC) for newborns in Sub-Saharan Africa is inadequate, with only 23.51% receiving optimal care. Factors like maternal education, wealth, and access to antenatal care influence adequate PNC provision.
Area of Science:
- Public Health
- Maternal and Child Health
- Demography
Background:
- Optimal postnatal care (PNC) is crucial for preventing maternal and neonatal mortality and long-term complications.
- Sub-Saharan Africa (SSA) faces the highest neonatal mortality rates globally.
- Adequate PNC content for newborns in SSA remains under-explored, necessitating research into influencing factors.
Purpose of the Study:
- To identify individual and community-level factors associated with adequate postnatal care (PNC) for newborns in Sub-Saharan Africa.
- To inform policymakers and program managers on targeted interventions to improve newborn PNC in the region.
Main Methods:
- Secondary data analysis of Demographic and Health Surveys from 21 SSA countries.
- Inclusion of a weighted sample of 105,904 respondents.
- Application of a multilevel binary logistic regression model to determine significant factors.
Main Results:
- Adequate PNC for newborns in SSA was found in 23.51% of cases.
- Positive associations with adequate PNC included: maternal age ≥35, higher maternal education levels, higher wealth status, increased antenatal care (ANC) visits (1-7 and 8+), and health facility delivery.
- Urban residence and low community poverty were also linked to adequate PNC, while residing in East, Central, or West African sub-regions showed lower odds.
Conclusions:
- The prevalence of adequate newborn PNC in SSA is low, demanding urgent attention.
- Key factors influencing adequate PNC include maternal age, education, wealth, ANC utilization, place of delivery, residence, community poverty, and sub-regional location.
- Intervention strategies should prioritize enhancing access to ANC services for vulnerable groups to improve newborn PNC.
Background:
No doubt providing optimal postnatal care (PNC) prevents both maternal and neonatal deaths, in addition to the prevention of long-term complications. Sub-Saharan Africa (SSA) had the highest neonatal mortality rate, despite this adequate content of PNC for the newborn is not explored in SSA, therefore, it is important to identify the factors affecting adequate content of PNC for the newborn in the region. This may assist the program and policymakers to give an intervention based on the findings of the study.
Methods:
A secondary data analysis was performed using 21 SSA countries' Demographic and Health Surveys. A total weighted sample of 105,904 respondents were included in this study. A multilevel binary logistic regression model was fitted. The odds ratios along with the 95% confidence interval were generated to determine the individual and community-level factors of adequate PNC for the newborn. A p-value less than 0.05 was declared as statistical significance.
Results:
Adequate PNC for newborns in sub-Saharan Africa was 23.51% (95% CI: 23.26, 23.77). Mothers age ≥ 35(AOR = 1.21,95% CI: 1.06,1.16), mothers' primary education (AOR = 1.18, 95% CI: 1.13, 1.23), secondary education (AOR = 1.58, 95% CI:1.51,1.66), higher education (AOR = 1.61,95% CI:1.49,1.75), rich wealth status (AOR = 1.05,95% CI = 1.01,1.10), ANC visits 1-7 (AOR = 1.61,95% CI:1.51, 1.73), antenatal care (ANC) visit 8 and above (AOR = 2.54,95% CI: 2.32, 2.77), health facility delivery (AOR = 4.37, 95% CI:4.16,4.58), lived in east (AOR = 0.23,95% CI = (0.20,0.26), central(AOR = 0.21,95% CI = 0.19,0.24), west African sub-regions (AOR = 0.23,95% CI = 0.21, 0.27), Urban dwellers (AOR = 1.22,95% CI: 1.17,1.27), and low community poverty (AOR = 1.21 (95% CI = 1.11,1.31) were associated with adequate content of PNC for the newborn.
Conclusion:
The finding of this study showed that the overall prevalence of adequate content of PNC for a newborn in SSA countries was low. The low prevalence of adequate content of postnatal care for newborns in SSA countries is a concerning issue that requires immediate attention. Age of the respondents, level of education, wealth status, ANC visits, place of delivery, residence, community-level poverty, and sub-region of SSA were the individual-level and the community-level variables significantly associated with adequate PNC for the newborn. Strategies should focus on increasing access to antenatal care services, particularly for vulnerable populations, such as younger mothers, those with lower education levels, and individuals residing in impoverished communities to improve PNC for the newborn.
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