Availability of Health Facilities and Utilization of Maternal and Newborn Postnatal Care in Rural Malawi

Citation

Kim, Eunsoo Timothy; Singh, Kavita; Speizer, Ilene S.; Angeles, Gustavo; & Weiss, William (2019). Availability of Health Facilities and Utilization of Maternal and Newborn Postnatal Care in Rural Malawi. BMC Pregnancy and Childbirth, 19, 503. PMCID: PMC6918704

Abstract

BACKGROUND: This study explored the role of health facility availability as it relates to maternal and newborn PNC use in rural Malawi.
METHODS: Malawi Demographic and Health Survey (MDHS) 2015-16 data, MDHS 2015-16 household cluster GPS data, Malawi Service Provision Assessment (MSPA) 2013-14 data and MSPA 2013-14 facility GPS data were used. Household clusters were spatially linked with facilities using buffers. Descriptive analyses were performed and generalized estimating equations (GEE) were used to determine the effects of having different types of facilities at varying distances from household clusters on receipt of maternal and newborn PNC in rural Malawi.
RESULTS: In rural Malawi, around 96% of women had facilities providing PNC within 10 km of where they live. Among women who have clinic-level facilities within 5 km of where they live, around 25% had clinic-level facilities that provide PNC. For rural women who gave birth in the past 5 years preceding the survey, only about 3% received maternal PNC within 24 h and about 16% received maternal PNC within the first week. As for newborn PNC, 3% of newborns had PNC within 24 h and about 26% had newborn PNC within the first week. PNC mostly took place at facilities (94% for women and 95% for newborns). For women who delivered at home, having a health center providing PNC within 5 km was positively associated with maternal and newborn PNC. For women who delivered at facilities, having a health center providing PNC within 5 km was positively associated with maternal PNC and having a health center providing PNC between 5 km and 10 km was positively associated with both maternal and newborn PNC. Regardless of the place of delivery and distance band, having a clinic-level facility providing PNC did not have significant positive effects on maternal and newborn PNC.
CONCLUSIONS: Providers should be trained to perform quality PNC at all facilities. It would also be important to address concerns related to health workers. Lastly, it would be key to increase community awareness about the importance of seeking timely PNC and about the utility of lower-level facilities for receiving preventative PNC.

URL

http://dx.doi.org/10.1186/s12884-019-2534-x

Reference Type

Journal Article

Year Published

2019

Journal Title

BMC Pregnancy and Childbirth

Author(s)

Kim, Eunsoo Timothy
Singh, Kavita
Speizer, Ilene S.
Angeles, Gustavo
Weiss, William

PMCID

PMC6918704

ORCiD

Speizer - 0000-0001-6204-1316
Angeles - 0000-0003-4598-152X
Singh, K - 0000-0001-8670-2262