Pooled prevalence of immediate postnatal care use and its associated factors in sub-Saharan Africa

Access to high-quality postpartum care, especially in the first week, is vital for reducing maternal and newborn mortality and morbidity. Despite its importance, immediate postnatal care remains one of the weakest areas in reproductive and child health programs. This study investigates the pooled prevalence and associated factors of immediate postnatal care utilization using recent demographic and health survey data from sub-Saharan Africa.

Data from the most recent demographic and health surveys conducted between 2015 and 2022 in 20 sub-Saharan African countries were analyzed. The study included a weighted sample of 66,514 women aged 15-49 with live births in the two years preceding the survey. Multilevel mixed-effects logistic regression identified factors associated with immediate postnatal care utilization. Statistical significance was declared at p-value < 0.05 with adjusted odds ratios (AOR) and 95% confidence intervals (CI).

The pooled prevalence of immediate postnatal care utilization was 64.06% (95% CI: 63.69%, 64.42%). Positive associations included older age [AOR = 1.27], higher education [AOR = 1.07], working [AOR = 1.23], having media exposure [AOR = 1.22], having ANC visits [AOR = 2.97], cesarean delivery [AOR = 1.49], intended pregnancy [AOR = 1.26], proximity to a health facility [AOR = 1.29], and urban residence [AOR = 1.05]. Negative associations included wealth index [AOR = 0.94], household head [AOR = 0.93], family size [AOR = 0.87], birth order [AOR = 0.85], community education [AOR = 0.87], and poverty level [AOR = 0.93].

Immediate postnatal care utilization remains below WHO recommendations. Enhancing education, media outreach, ANC services, pregnancy planning, and targeted support for vulnerable groups, such as younger, unemployed, rural women and those distant from health facilities, is essential for improving maternal and newborn outcomes.