ASSESSMENT OF POSTNATAL CARE SERVICES IN SELECTED HEALTH CARE FACILITIES IN ABEOKUTA METROPOLIS, OGUN STATE, SOUTHWEST NIGERIA

Abstract

High quality maternal care should be a continuum that spans from the pre-pregnancy to the postpartum period. Postnatal care is an important link in the continuum of care for the mother and child. Postnatal period is a vulnerable time because most maternal deaths occur during this period, yet postnatal care is very poor and inadequate in Nigeria, Ogun State has the second highest maternal mortality ratio in southwest Nigeria. Analysis of the State maternal deaths surveillance data revealed that most deaths occurred postpartum. Therefore, this study assessed the quality of PNC and identified barriers to the delivery of quality PNC services in the State. A facility based crossectional study was conducted between January and April 2018 among 420 postpartum women and 142 midwives using multistage sampling technique. The study was conducted in Abeokuta, Ogun State, Southwest Nigeria. We used the "WHO frame work for assessing quality of maternal health services" which assessed several attributes of maternal health service delivery to determine the structure, process, and outcome components of quality of care. WHO adapted facility checklist was used to assess the adequacy of postnatal infrastructures in the HFs. A pre-tested semi-structured questionnaire was used to assess the knowledge and practices of midwives towards maternal PNC services. A pre-tested semi-structured interviewer administered questionnaire was also used to asses women satisfaction towards postnatal care services offered. SPSS version 20 software was used to analyze findings, associations between variables and other factors were tested using Chi-square at a-level of 0.05. The midwives were female with mean age (SD) of 44.3 (8.9) years. The mean age (SD) of women assessing PNC was 29.5 (5.4) years. Two hundred and sixty-eight (64%) of the respondents were Christians while One hundred and fifty-one (35%) were Muslims. Only one of the HFs had adequate PNC structure. Sixty three (44.6%) midwives had good knowledge on PNC while lQl (71%) had go~d practices. Three hundred and fifty (85.8%) postpartum women were satisfied with PNC services offered while 250 (62.5%) postpartum women were dissatisfied with the cost of PNC. No factor was significantly associated with midwives knowledge on PNC and client satisfaction of services rendered. In conclusion, structures for providing postnatal care services were inadequate. The midwives had poor knowledge of postpartum care. The women assessing postnatal care were satisfied with the services received. We recommend refresher training for midwives; HFs should be adequately equipped with postnatal care infrastructures and integration of post natal care into the existing health insurance package in the State.