Determinants of postnatal care non-utilization among women in adama district, East Shwoa Ethiopia a community-based unmatched case-control study

Abstract

Background Maternal and neonatal mortality remain a significant problem across much of the developing world, especially in sub-Saharan Africa countries. In Ethiopia, most maternal and neonatal deaths occur during the postpartum period; this is a critical time for monitoring the health of women and newborns, but the most neglected period for care. In rural communities of Ethiopia, the utilization of postnatal care service is very low and evidence on which factors contribute to the non-utilization of postnatal care (PNC) is insufficient. Consequently, this study was designed to identify the determinants of postnatal service non-utilization among women who gave birth in Adam district, East central Ethiopia. Methods A community-based unmatched case-control study was conducted among 186 cases (postnatal care non-utilizers) and 186 controls (postnatal care utilizers) in Adama district from January 1 to February 10, 2024. A previously tested interviewer-administered structured questionnaire was used for data collection. Binary logistic regression analysis was performed. In the final multivariable logistic regression analysis model, a p-value of less than 0.05 and an Adjusted Odd Ratio (AOR) with a 95% confidence interval was used to determine variables for postnatal care non-utilization. Result Educational status (no formal education) (AOR = 2.70; 95% CI: 1.23–1.75. Inadequate knowledge of post-natal (AOR = 4.6; 95% CI; 1.80–5.90). Having no ANC attended (AOR = 2.00; CI: 1.30–5.20).home delivery (AOR = 1.7; 95% CI: 1.40–4.50). And distance from the nearest health facility were independent determinants of postnatal non utilization Conclusions This study revealed that educational statues, home delivery, no ANC non-attendance, inadequate knowledge on post-natal care, home delivery found to be the determinants of PNC service non utilization. Therefore, encouraging ANC, institutional delivery, along with integrated and improving awareness on postnatal care services, will improve postnatal care service utilization in the districts of Ethiopia.