Post natal care in Bubi district deserves more attention

Abstract

Objectives: To establish whether, where and when women in Bubi District attend Post Natal Care (PNC), the factors that influence attendance, the quality of services and traditional or cultural practices felated to PNC. Design: A cross sectional survey. Setting: Bubi District, Matebeleland North Province, Zimbabwe. Subjects: A multistage sample of 200 women with a child aged three to 12 months, convenience samples of .96 women with a child zero to 12 months who had attended PNC; 112 elderly women from the community and 10 nurses. Main Outcome Measures: PNC attendance, place and timing of PNC visit, quality of PNC, knowledge and attitudes towards PNC and traditional practices Results: 61% of the women had attended PNC. Factors associated with non-attendance were higher age and parity, home delivery and long distance between home and health facility. Almost all women attended PNC in a district health facility. Eighty three percent were seen at six weeks post par turn. Forty percent of the mothers and 36.1% of the babies had received a full examination, but 37.7% and 4.9% respectively had not been examined at all. Nine of the 10 nurses interviewed were not aware of a PNC policy. Knowledge on PNC among the women in the community was poor. Some potentially beneficial and harmful traditional practices related to mother and baby were identified. Conclusion: PNC attendance in this study was almost three times the attendance reported through the routine National Health Information System, but lower than elsewhere in Zimbabwe. The quality of the services was rather poor and more geared towards the baby than the mother. Both health workers and the community need to better understand the importance of PNC. Because the first two weeks postpartum is the period with highest morbidity and mortality, women should be advised to make a PNC visit within 14 days, or whenever they have problems, rather than at six weeks. All health facilities, including the mobile teams should be able to offer PNC. There is need to develop an ‘ evidence-based’ PNC policy to guide nurses on what to offer to both mother and baby, also taking into consideration common traditional practices.