Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi
Abstract Background A number of studies in the past have looked at determinants of postnatal care. However, many of them do not distinguish between postnatal care (PNC) before discharge and after discharge for women delivering at health facilities. Conceptually and practically, factors associated wi...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-020-4958-4 |
| _version_ | 1819230006376660992 |
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| author | Eunsoo Timothy Kim Kavita Singh Ilene S. Speizer Clara Lemani |
| author_facet | Eunsoo Timothy Kim Kavita Singh Ilene S. Speizer Clara Lemani |
| author_sort | Eunsoo Timothy Kim |
| collection | DOAJ |
| description | Abstract Background A number of studies in the past have looked at determinants of postnatal care. However, many of them do not distinguish between postnatal care (PNC) before discharge and after discharge for women delivering at health facilities. Conceptually and practically, factors associated with PNC before discharge and after discharge should be different. This study examines key factors for maternal and newborn PNC before discharge. Methods Data from the 2015–16 Malawi Demographic and Health Survey were used for the study. Three categorical endogenous variables examined in the study were whether or not mothers received a postnatal check between birth and facility discharge, whether or not newborns received a postnatal check between birth and facility discharge and whether or not women delivered by cesarean section. Delivery by cesarean section was considered as a mediator in the model. The main predictor of interest was type of health facility where women delivered. Other exogenous variables included were women’s age at most recent birth, number of antenatal visits, women’s education, household wealth, parity, newborn size, region of the country and residence. Simultaneous equation modeling was used to examine the associations of interest. Results 47% of the mothers and 68% of the newborns had PNC before facility discharge. The total and direct effects of delivering in private hospitals on maternal and newborn PNC before facility discharge were significantly higher than the effects of delivering in government hospitals. The total effects of delivering in government health centers or health posts on maternal and newborn PNC before facility discharge were significantly lower than the effects of delivering in government hospitals. Delivering by cesarean section compared to delivering vaginally was positively associated with maternal and newborn PNC before facility discharge. Conclusion It is important that all women and newborns receive PNC before they are discharged from the facility regardless of whether or not they had a complication. The same standard of quality PNC should be provided equitably across all types and affiliations of health facilities. |
| first_indexed | 2024-12-23T11:22:12Z |
| format | Article |
| id | doaj.art-f6203fc53da14348ad75ea372a22ce6c |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-23T11:22:12Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-f6203fc53da14348ad75ea372a22ce6c2022-12-21T17:49:03ZengBMCBMC Health Services Research1472-69632020-02-0120111210.1186/s12913-020-4958-4Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in MalawiEunsoo Timothy Kim0Kavita Singh1Ilene S. Speizer2Clara Lemani3Duke Global Health Institute, Duke UniversityDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel HillUNC Project – MalawiAbstract Background A number of studies in the past have looked at determinants of postnatal care. However, many of them do not distinguish between postnatal care (PNC) before discharge and after discharge for women delivering at health facilities. Conceptually and practically, factors associated with PNC before discharge and after discharge should be different. This study examines key factors for maternal and newborn PNC before discharge. Methods Data from the 2015–16 Malawi Demographic and Health Survey were used for the study. Three categorical endogenous variables examined in the study were whether or not mothers received a postnatal check between birth and facility discharge, whether or not newborns received a postnatal check between birth and facility discharge and whether or not women delivered by cesarean section. Delivery by cesarean section was considered as a mediator in the model. The main predictor of interest was type of health facility where women delivered. Other exogenous variables included were women’s age at most recent birth, number of antenatal visits, women’s education, household wealth, parity, newborn size, region of the country and residence. Simultaneous equation modeling was used to examine the associations of interest. Results 47% of the mothers and 68% of the newborns had PNC before facility discharge. The total and direct effects of delivering in private hospitals on maternal and newborn PNC before facility discharge were significantly higher than the effects of delivering in government hospitals. The total effects of delivering in government health centers or health posts on maternal and newborn PNC before facility discharge were significantly lower than the effects of delivering in government hospitals. Delivering by cesarean section compared to delivering vaginally was positively associated with maternal and newborn PNC before facility discharge. Conclusion It is important that all women and newborns receive PNC before they are discharged from the facility regardless of whether or not they had a complication. The same standard of quality PNC should be provided equitably across all types and affiliations of health facilities.http://link.springer.com/article/10.1186/s12913-020-4958-4Postnatal careFacility deliveryQuality of carePublic facilitiesCesarean sectionMalawi |
| spellingShingle | Eunsoo Timothy Kim Kavita Singh Ilene S. Speizer Clara Lemani Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi BMC Health Services Research Postnatal care Facility delivery Quality of care Public facilities Cesarean section Malawi |
| title | Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi |
| title_full | Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi |
| title_fullStr | Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi |
| title_full_unstemmed | Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi |
| title_short | Influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in Malawi |
| title_sort | influences of health facility type for delivery and experience of cesarean section on maternal and newborn postnatal care between birth and facility discharge in malawi |
| topic | Postnatal care Facility delivery Quality of care Public facilities Cesarean section Malawi |
| url | http://link.springer.com/article/10.1186/s12913-020-4958-4 |
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