Changes in postnatal outcomes following implementation of a family-led postnatal care model: A pre-post intervention study in Ada'a District, Ethiopia

Postnatal care is crucial for assessing the health of both mother and newborn, yet its coverage remains low in Ethiopia. Timely, high-quality postnatal care, especially within the first week after birth, is essential to reduce maternal and neonatal mortality rates. Family-led postnatal care is an innovative model for reaching postnatal mothers and newborns during the first week of life. Leveraging self-care principles, mothers, with the support from family, perform daily postnatal health checks on themselves and their newborns. This study evaluated the effect of a family-led postnatal assessment intervention on coverage of postnatal checks within seven days of birth. This study used pre- and post-intervention cross-sectional surveys in four health centers. Eligible postnatal mothers who gave birth in the study health centers were interviewed pre- (November 2022-Jan 2023) and post-intervention (February to April 2023) using a structured questionnaire. Bivariate tests and descriptive analyses were used to assess changes in postnatal check coverage over time. Surveys were completed with a total of 119 mother pre-intervention and 110 mother post-intervention. In the pre-intervention period, nine percent (11/119) mothers and 11% (13/119) newborns had a postnatal check between 24 and 72 hours after birth, whereas during the post-intervention period this increased to 96% (105/110) mothers and 96% (105/110) newborns (P < 0.0001). There was a similar increase in the proportion of mothers and newborns having postnatal checks between 73 hours and 7 days (3% vs. 96%, P < 0.0001). Compared to pre-intervention, a larger proportion of mothers detected a maternal danger sign during the post-intervention period (6.7% vs 18.2%, P < 0.008). Family-led postnatal care is a promising self-care model that increased postnatal checks for mothers and newborns who would not otherwise have received care. Evaluating this model in other settings with more rigorous design is recommended. ClinicalTrials.gov (NCT05563974), first posted on 3rd October 2022.