Effectiveness of A Community Level Maternal Health Intervention in Improving Uptake of Postnatal Care in Migori County, Kenya

Abstract

Background: Provision of a continuum of care during pregnancy, delivery, and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Complications and lack of skilled postnatal care has consequences for mothers and babies. We examined to what extent a community level integrated maternal health intervention contributed to improvements in uptake of skilled care after delivery by pregnant women. Methods: An Ex post quasi-experimental design was applied. Among 590 reproductive-aged women, we assessed the effectiveness of a community level integrated maternal health intervention and predictors of uptake of postnatal care. Descriptive, bivariate and multivariate analyses were conducted. Results: About three fifths (64%) of the women reported having sought postnatal care services at the health facility within six (6) weeks. Women in the intervention arm were 3.3 times more likely to take up postnatal care at a health facility (AOR= 3.31[95% CI 1.245 to 8.804] p=0.016). Women referred to the health facility for postnatal care by Community Health Workers (CHWs) were 2.72 times more likely to take up the services (AOR= 2.72[95% CI 1.05 to 7.07] p=0.039) than those not referred by CHWs. Distance to health facility (61%) was the major barrier, while some mothers did not feel the need for postnatal care (11%). Conclusion and Implications for Translation: Routine health education by trained providers at community level health facilities, coupled with enhanced CHWs’ involvement can improve uptake of postnatal care. Ignorance and accessibility challenges are some barriers to the uptake of postnatal care.