Utilization of skilled attendants by postnatal mothers in Chipata District, Eastern Province, Zambia

Abstract

ABSTRACT Background-.Post-natal care assisted by a skilled attendant ensures the survival and health of the mother and her new-born. Despite the improvement in hospital deliveries, most postnatal mothers do not attend postnatal care for the recommended number of visits. A skilled attendant is an accredited health professional such as a midwife, doctor or nurse trained to proficiency in the skills needed to manage normal pregnancy, childbirth and the immediate postnatal period. Underutilization of skilled attendants after birth is still a major source of concern in the Sub Saharan African Countries Zambia inclusive. Evidence shows that the highest incidence of maternal and perinatal mortality occurs within the postnatal period. Aim-The main objective of the study was to determine the factors that influence utilization of skilled attendants by postnatal mothers in Chipata District. Methodology- A cross sectional study design using quantitative approach was done in Chipata District. The sample size for this study was 176 postnatal mothers who were systematically selected from twelve (12) selected research setting. A pretested semistructured interview schedule was used to collect data. Data was analysed using Statistical Package for Social Sciences (SPSS) version 22 program and chi-square test was used to test significant associations. Binary logistic regression modeling was employed to predict the outcome. Results-The study findings revealed that 125 (71%) did not utilize the skilled attendants. A significant association was observed between utilization of skilled attendants by postnatal mothers and knowledge levels on postnatal care (p=0.005). Binary logistical regression showed that all independent variables did not contribute significantly to the model (p value> 0.05).The odds of utilizing skilled attendants for those with moderate knowledge levels were 2.083 times [OR, (95% CI) 2.083= (0.987, 4.399)] higher than those with low knowledge levels.The odds of utilizing skilled attendants for those with education levels of secondary and above were 1.4 times [OR, (95% CI) = 1.403 (0.579, 3.399)] higher than for those below secondary education. Conclusion -The results suggest that underutilization of skilled attendants remain a major challenge in Chipata District. The study also revealed that postnatal mothers had moderate levels of knowledge on importance of postnatal care. Service related factors and cultural beliefs did not influence utilization of skilled attendants in this study. Only knowledge was significantly associated with utilization of skilled attendants. There is need to advocate for skilled attendance and increased awareness to postnatal mothers on the value of postnatal checkups and care. There is also need to research further on whether skilled attendants have adequate knowledge and skill in managing postnatal mothers. Key words: Utilization, Skilled attendant, Postnatal care