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Background: High neonatal mortality rates continue to be a major public health issue in Ethiopia. Despite different maternal and neonatal care interventions, neonatal mortality in Ethiopia is at a steady state. This could be due to the low utilization of neonatal checkups. Thus, nationally assessing the level and predictors of postnatal checkups could provide important information for further improving neonatal healthcare services. Materials and Methods: A secondary data analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS) was performed on 7,586 women who had live births in the 2 years before the survey. All variables with a p-value of ≤0.25 in the bivariable analysis were entered into the final model for multivariable analysis, and the level of statistical significance was declared at a P-value of <0.05. Results: According to the national survey, only 8.3% [95% CI: 8.19, 8.41] of neonates received postnatal checkups. About two-thirds of women, 62.8% had antenatal care visits, 67.9%, gave birth at home, and 95.7% were unaware of neonatal danger signs. Distance from health care institutions [AOR = 1.42; 95% CI: 1.06, 1.89], giving birth in a healthcare facility [AOR = 1.55; 95% CI: 1.12, 2.15], antenatal care visit [AOR = 3.0; 95% CI: 1.99, 4.53], and neonatal danger signs awareness [AOR = 3.06; 95% CI: 2.09, 4.5] were all associated with postnatal care visits. Conclusion: The number of neonates who had a postnatal checkup was low. Increasing antenatal care visit utilization, improving institutional delivery, raising awareness about neonatal danger signs, increasing access to health care facilities, and implementing home-based neonatal care visits by healthcare providers could all help to improve postnatal checkups.
The data was taken from the 2016 EDHS report, which was conducted from January 18 to June 27, 2016. In Ethiopia, there are nine regional states and two city administrations. Each region was stratified into urban and rural areas. Stratified two-stage cluster sampling was performed. Samples of enumeration areas (EAs) were selected independently in each stratum in two stages. A total of 645 EAs (202 in urban areas and 443 in rural areas) were selected with a probability proportional to EA size. The full details are available from reference 16 (16). Lists of households were used as a sampling frame for the second stage of household selection, and a fixed number of 28 households per cluster were chosen with an equal probability of systematic selection from the newly created household listing. The study population consisted of women with postpartum with a baby in the selected enumeration areas (EAs) and all postpartum mothers who had neonates in Ethiopia (16). The data was extracted from 7,586 women with postpartum. The approval letter was obtained from the measure demographic and health survey (DHS), and the data set was downloaded from the DHS website1. All women with postpartum aged 15–49, who were either permanent residents or visitors who stayed in the selected households the night before the survey, were eligible. Dependent variable: The primary outcome of interest was postnatal checkups for neonates (PNC). This variable was dummy-coded, so respondents who reported having PNC checkups for neonates were coded as “Yes,” while those who did not have PNC checkups were coded as “No.” A postnatal care visit for a neonate was defined as at least one PNC visit within the first 42 days of the neonate’s postpartum period (25). Socio-demographic variables: Age of the mother’s residence (urban or rural), religion, marital status, and educational status (no education, primary education, secondary education, and above education). Antenatal care visit (ANC) is defined based on self-reported frequency of any ANC services provided by skilled healthcare providers in the healthcare institutions, and categorized as “Yes” for any ANC visit and “No” for no ANC visit. Place of delivery: Refers to whether the delivery was at a healthcare institution or home. Fertility-related factors include the most recent child’s birth order (1st, 2nd, 3rd, 4th, etc.). Mode of delivery: How did you give birth (vaginally, C/S, or instrumentally)? Facility-related variables include the mother’s perceived distance from home to a health facility categorized as a “big problem” or “not a big problem.” Data cleaning, recording, and analysis were carried out using SPSS statistical software version 24. Sample weight was applied to all analysis procedures to account for complex survey design and unequal probabilities of selection. A Rao-Scott chi-square test that adjusts for complex sample design was used to examine the bivariate associations between each covariate and the outcome variable. The data was a national survey data set with a hierarchical and cluster nature, which emphasizes the need for us to use a multilevel model of analysis. To use this model, the interclass calculation should be calculated, and be greater than 10%. The ICC in the current study was found to be 8.9%, which is lower than expected. As such, we used the binary logistic regression model. All variables with a p-value of ≤0.25 in the bivariable analysis were entered into the final model for multivariable analysis, and variables with p-values of <0.05 in the multivariable binary logistic regression model analysis were considered statistically significant. Finally, the result was presented using frequencies, tables, and texts.
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