Factors affecting the utilisation of postpartum care among young mothers in Bangladesh

This article was published in the Health and Social Care in the Community [© 2010 Blackwell Publishing Ltd.] and the definite version is available at : http://doi.org/10.1111/j.1365-2524.2010.00953.x. The Journal's website is at: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2524.2010.00953.x/abstract;jsessionid=B37DAD816A8607C815ADF16E5CFA7685.f03t02This article addresses the hypothesis that predisposing, enabling and need factors of households influence utilisation of postpartum care among the young mothers according to the timing and type of providers. To reach our goal Bangladesh Demographic and Health Survey of 2007 data (n=2376) were used. Findings revealed that only one-third of the young mothers received postpartum care. Postpartum care by medically trained personnel and within the most critical period (within 48h after delivery) was found to be very low (25.5 and 16.6%). Regarding postpartum morbidities, only one-fifth to one-half of the women reporting a complication consulted medically trained providers. Indeed, between one third and two thirds did not seek any postpartum care. The highest percentages contacting healthcare providers were for convulsions and the lowest was when the baby's hands or feet came first. The stronger influence of the mother's education and antenatal care on the utilisation of postpartum care is consistent with findings from other studies. Concern of the husband or family about pregnancy complications showed a significant and positive impact on the utilisation of postpartum care. Multivariate analysis showed that mother's age at delivery, residence, education, antenatal care, place of delivery, wealth, husband's occupation, husband's concern about pregnancy complications and mother's permission to go to a health centre alone were likely to affect utilisation of postpartum care services. The results indicate urgent needs in Bangladesh for an awareness-raising program highlighting the importance and availability of postpartum care; for strategies to improve the availability and accessibility of antenatal care services and skilled birth attendance, including focused financial support; for women's education to be given high priority; and to enable women to exercise their rights to control their freedom of movement, own health care and access to economic resources