FACTORS AFFECTING UTILIZATION OF POSTNATAL CARE SERVICES AT KABIRA HEALTH CENTRE III MITOOMA DISTRICT SOUTH WESTERN UGANDA

TABLE OF CONTENTS

DECLARATION ............................................................................................................................ ii

APPROVAL ..................................................................................................................................iii

DEDICATION............................................................................................................................... iv

ACKNOWLEDGEMENT.............................................................................................................. v

TABLE OF CONTENTS............................................................................................................... vi

LIST OF FIGURES ........................................................................................................................ x

LIST OF TABLES......................................................................................................................... xi

LIST OF ABBREVIATIONS AND ACRONYMS ..................................................................... xii

DEFINITION OF TERMS ..........................................................................................................xiii

ABSTRACT................................................................................................................................. xiv

CHAPTER ONE............................................................................................................................. 1

INRODUCTION............................................................................................................................. 1

1.0 Introduction............................................................................................................................... 1

1.1 Background to the study ........................................................................................................... 1

1.2 Statement of the Problem.......................................................................................................... 3

1.3 General Objective/Aim of the study ......................................................................................... 3

1.3.1 Specific objectives................................................................................................................. 3

1.3.2 Research questions................................................................................................................. 4

1.4 Significance of the study........................................................................................................... 4

1.5 Scope of the study..................................................................................................................... 4

CHAPTER TWO ............................................................................................................................ 5

LITERATURE REVIEW ............................................................................................................... 5

2.0 Introduction............................................................................................................................... 5

2.1 General introduction to the role of PNCin Maternal Child health services.............................. 5

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2.2 Socio-demographic factors affecting Post-natal care ............................................................... 6

2.3 Health system factors affecting utilization of PNC .................................................................. 8

2.4 Summary................................................................................................................................... 9

CHAPTER THREE ...................................................................................................................... 10

METHODOLOGY ....................................................................................................................... 10

3.0 Introduction............................................................................................................................. 10

3.1 Study design............................................................................................................................ 10

3.2 Study population ..................................................................................................................... 10

3.3 Sample size determination ...................................................................................................... 10

3.4 Sampling Procedure and rationale .......................................................................................... 10

3.5 Data collection tools ............................................................................................................... 11

3.6 Data collection procedure/method .......................................................................................... 11

3.7 Piloting the study .................................................................................................................... 11

3.8 Inclusion and exclusion criteria .............................................................................................. 11

3.8.1 Inclusion criteria .................................................................................................................. 11

3.8.2 Exclusion criteria ................................................................................................................. 12

3.9 Data Analysis and presentation............................................................................................... 12

3.10 Ethical consideration............................................................................................................. 12

3.11 Limitations for the study....................................................................................................... 13

3.12 Dissemination of results........................................................................................................ 13

CHAPTER FOUR......................................................................................................................... 14

RESULTS ..................................................................................................................................... 14

4.0 Introduction............................................................................................................................. 14

4.1 Demographic characteristics of the respondents..................................................................... 14

4.2 Utilization of PNC services .................................................................................................... 15

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4.2.1 Uptake of PNC care services ............................................................................................... 15

4.2.2 Timing of the first PNC visit ............................................................................................... 16

4.2.3 Reasons for attending PNC services.................................................................................... 17

4.2.4 Reasons for not attending PNC services.............................................................................. 18

4.3 Socio-demographic factors influencing utilization of PNC services...................................... 19

4.3.1 Association between age and PNC utilization..................................................................... 19

4.3.2 Association between education status and PNC service utilization..................................... 19

4.3.3 Association between religion and PNC utilization .............................................................. 20

4.3.4 Association of marital status and PNC utilization ............................................................... 20

4.3.5 Association of parity and PNC utilization ........................................................................... 21

4.3.6 Association between Employment status and PNC services............................................... 21

4.3.7 Association between spouse’s education and PNC utilization ............................................ 22

4.3.8 Association between wealth status and PNC utilization...................................................... 22

4.4 Health system factors.............................................................................................................. 23

4.4.1 Association between distance to the health facility and PNC utilisation............................. 23

4.4.2 Association between mode of transport to the health facility and PNC utilisation. ............ 23

4.4.3 Association between place of delivery and utilization of PNC services ............................. 23

4.4.4 Association between 4th ANC visit and Utilisation of PNC services.................................. 24

4.4.5 Quality of care and utilisation of PNC services................................................................. 25

4.4.5.1 Quality of care studied...................................................................................................... 25

4.5 Women’s knowledge about PNC services.............................................................................. 25

CHAPTER FIVE .......................................................................................................................... 27

DISCUSSION, CONCLUSION AND RECOMMENDATIONS................................................ 27

5.0 Introduction............................................................................................................................. 27

5.1 Discussion............................................................................................................................... 27

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5.1.1 Introduction.......................................................................................................................... 27

5.1.2 Utilization of PNC services ................................................................................................. 27

5.1.3 Socio-Demographic Determinants of PNC Utilization........................................................ 27

5.1.4 Health system factors associated with PNC utilization ...................................................... 28

5.1.5 Knowledge about and attitude towards Utilization of PNC utilization. .............................. 29

5.2 Conclusion ............................................................................................................................. 30

5.3 Recommendations................................................................................................................... 30

REFERENCIES ............................................................................................................................ 31

APPENDIX ONE: QUESTIONNAIRE ....................................................................................... 33

APPENDIX II: KEY INFORMANT INTERVIEW GUIDE ....................................................... 38

APPENDIX III: A map of Uganda showing location of Mitooma District.................................. 40

APPENDIX IV: MAP OF MITOOMA DISTRICT SHOWING SUBCOUNTIES..................... 41

APPENDIX V: MORGAN’S TABLE.......................................................................................... 42