Factors associated with the utilization of postnatal care services among Malawian women

Introduction: The World Health Organization (WHO) recommends that every woman be checked after the delivery of a child. However, only 42% of Malawian women are checked by a skilled health worker within 48 hours after delivery. This study aimed at identifying factors associated with postnatal care (PNC) utilization among Malawian women by using nationally representative data. Methods: Secondary data from the 2015-2016 Malawi Demographic and Health Survey (MDHS) was used for the study. A logistic regression model was used to find the adjusted odds of utilizing PNC services among the women. All the analyses controlled for the survey clusters and weighting. All the analyses were conducted in STATA version 14 at a significance level of 5%. Results: Out of the 6,693 women who had a live birth 24 months prior to the 2015-2016 MDHS, only 48.4% were checked by a skilled health worker within 42 days after delivery. Uptake of PNC was significantly associated with older age, being employed, living in an urban area, delivery through caesarean section, a timely first antenatal care (ANC) visit, uptake of recommended number of ANC visits, and receiving the adequate number of tetanus injections. Conclusion: Interventions to increase utilization of PNC services should be tailored to appropriate populations. Particularly, special focus has to be made towards younger women, the women who reside in the rural areas, who are not employed, and who are generally not well to do. Behavioural change interventions must also target women with low perceived risk after delivery. Information should also be consistently provided by health workers in communities and health facilities to women on perinatal care in order to change the women's risk perception on all levels of pregnancy care and to encourage utilization of relevant health services.