Exploring the quality and effect of comprehensive postnatal care models in East and Southern Africa

Every year in Africa, at least 125,000 women and 870,000 newborns die in the first week after birth, yet this is when coverage and programmes are at their lowest along the continuum of care. The first day is the time of highest risk for both mother and baby. In high countries with HIV prevalence, women living with HIV are at increased risk during the postnatal period. Moreover many postnatal women have an unmet need for family planning in the year following birth with limited access to long acting reversible contraception or permanent methods. The fact that 18 million women in Africa currently do not give birth in a health facility poses challenges for planning and implementing postnatal care for women and their newborns. Regardless of place of birth, mothers and newborns spend most of the postnatal period (the first six weeks after birth) at home. Postnatal care programmes are among the weakest of all reproductive and child health programmes in the region. With this in mind this thesis set out to determine to what extent the provision of timely and improved quality of maternal and newborn health services in the much neglected postnatal period would result in increased uptake of a range of postnatal services and improve care and follow-up of postnatal women and their infants