|Determinants of Postnatal Care Services Utilization in Pakistan- Insights from Pakistan Demographic and Health Survey (PDHS) 2006-07|
||Asma Yunus, Sarosh Iqbal, Riffat Munawar, Rubeena Zakar, Shahzad Khaver Mushtaq, Fozia Sadaf, and Ahmad Usman
||Middle-East Journal of Scientific Research , 18(10): 1440-1447; DOI: 10.5829/idosi.mejsr.2013.18.10.12418
Health care utilization
||Background: Pakistan is amongst the countries with high rates of maternal and neonatal mortality. Most of the deaths occur at the time of childbirth or immediately in the period after birth due to low utilization of routine postnatal care (PNC). There is scarcity of literature on determinants and impeding factors of PNC services utilization in Pakistan. This paper provides a holistic view and investigates the association of PNC services utilization with socio-demographic and delivery assistance related characteristics.
Methods: The study used data from 2006-07 Pakistan Demographic and Heath Survey (PDHS), a nationally representative sample of 10,023 women aged 15-49 years. Our analysis was limited to the last birth during five years preceding the survey, total of 5,724 women. For measuring the PNC utilization, four variables i.e., utilization of PNC services, newborn PNC within 2 months, timing for PNC checkups and obstetric complications faced during PNC were combined. To check the association among the determinants of PNC, socio-demographic and other assisting variables certain momentous statistical techniques like Univariate, Bivariate and Multivariate logistic regression analysis were applied.
Results: The analysis of data showed that about 64% women received some ANC for their last born child and among them about half received ANC in the first trimester. About 42% received health professionals’ assistance during delivery; only 36.9% delivered in a health care facility. The findings revealed that women’s place of residence like urban or rural played significant role in the whole problem of the research mainly due to its relationship with education and socio-economic status.. The results also shown that women’s level of education i.e., more than ten years of schooling versus no schooling (AOR 5.16, 95%CI 3.18-9.98), high socioeconomic status than low status (AOR 5.69, 95%CI 4.27-7.58), economically developed regions than less developed ones (AOR 2.89, 95%CI 2.25-3.71), having two or less children than five or more children (AOR 2.08, 95%CI 1.83-2.38) and having a history of abortion than no abortion (AOR 1.51, 95%CI 1.25-1.82) were significantly associated with ANC utilization. Similarly, all these variables were significantly associated with ANC utilization in the first trimester, delivery assistance by health professionals and delivery in a medical facility.
Conclusions: The research found that women live in developed provincial settings with higher education, living in urban and prosperous areas, having fewer children and have more access to health services were more likely to use PNC services. The results may be useful for policymakers to develop efficient strategies to improve the health care services utilization in Pakistan.
Key words: Pakistan, ANC utilization, PNC services, PDHS