Assessment of utilization of postpartum care services among women in Webuye West, Bungoma County, Kenya

Abstract

Background: Postpartum care (PPC) is an important link in the continuum of care for maternal health. PPC services are essential, aim being to prevent any complications, poor outcomes like morbidity and mortality to ensure a healthy mother. The postpartum period is critical because most maternal deaths occur during this time, yet this is the most neglected period for quality care provision.

Objective: To assess utilization and factors influencing utilization of PPC services among women in Webuye West, Bungoma County, Kenya.

Design: A descriptive cross sectional study.

Setting: Webuye West, Bungoma County, Kenya.

Subjects: All women of reproductive age with living children aged 6-9 months.

Results: The study revealed that 33.6% utilized PPC services; poor attendance of mandatory visits at less than 40 %, and all visits being positively correlated (r p 0.000) to utilization. On socio cultural factors 85.8% reported staying indoors for specified period influenced use of PPC services and 57.3% stated that traditions demand them to do so. Cultural beliefs and practices are performed and seclusion of up to one month of this 55.7% attested to. Religious beliefs and practices was dependent on use of PPC by 59.4% (X² p=0.011).On knowledge majority 70.6% knew the services during ANC and from HCWs, but less than 15.4% and 28.2 % knew the mandatory and targeted visits respectively. The 1st and 4th visits being dependent on utilization (X², p<0.001). On health facility factors the mean distance to facilities is 1.78 km. Even though the majority of available service was basic, majority, 74.8% reported availability with 40.9% having received the services during all their visits. Majority 75.9% of HCWs were friendly and helpful. Half of the women paid for services and average waiting time was 31-60 minutes.

Conclusion: PPC service utilization is low marked by poor attendance of visits. Utilization of PPC is dependent on; religious beliefs and practices (X²=0.011), Knowledge on sources of information from MCH booklets and ANC visits (X² p<0.001); knowledge on who to attend after birth (X², p<0.001) and timings of PPC visits. Health facility related factors are availability of HCW, their helpfulness and friendliness and waiting time (X²p<0.001). Distance to the health facility and charges for services (X² p=0.005).