Determinants of Postnatal Service utilization in a Western District of Nepal: Community Based Cross Sectional Study

Background: Postnatal care of mothers is essential to reduce maternal morbidity and mortality. The objective of this study was to examine the factors affecting the utilization of postnatal service among the mothers who were currently having young children aged 6 weeks to 23 months in Kapilvastu district of western Nepal. Method: This was a community based cross sectional study conducted from January to February, 2012. Utilization of Postnatal Care (PNC) was reported in proportion. Factors associated with utilization of services were examined by using chi square test followed by regression analysis. Results: Of the 223 participants, 25.1% attended any PNC, 13.5% attended early PNC (within 24 hours of delivery) and 19.3% sought PNC service from health workers. The mothers who consumed iron tablet during pregnancy, who delivered in health facility, and who experienced danger signs during pregnancy were more likely to attend PNC services. The mothers who attended four or more ANC visits; had delivey assisted by health workers; had delivery at health faclity; consumed iron tablet during pregnancy; and attended secondary and above education were more likely to utilize early PNC services than their counterparts. Mothers who had completed secondary or higher education; had attended four or more ANC services or 1-3 ANC visits; who had ANC services by health workers; who had taken iron tablet during pregnancy and who were affected by danger signs during delivery were more likely to receive PNC from health workers than their counterparts. Conclusion: This study revealed that uptake of postnatal care service was very low. Home visits of postnatal mothers by health workers could be effective approach to increase the uptake of PNC services. Initiating incentive schemes for health workers or the mothers could be future direction for intervetion studies to increase postanatal service utilization in Nepal.