FACTORS AFFECTING UTILIZATION OF ANTENATAL AND POSTNATAL SERVICES IN PUNJAB, PAKISTAN

Abstract

Antenatal and Postnatal services are one of the most important maternal healthcare services for the prevention of impairments and disabilities resulting from childbirth. The present study has been designed to probe into the factors and believes behind utilization of antenatal and postnatal services. The study was conducted In the Punjab, the largest and most populated, province of Pakistan. The study was intended to gain immediate knowledge and information on attitudes and trends regarding utilization of antenatal and postnatal services in the Punjab Province. Three districts i.e. Rawalpindi, Faisalabad and Multan were selected through simple random sampling techniques. Out of the selected three districts two tehsils were selected from each district through random sampling technique. From each tehsil two union councils were selected and from each union council two villages were selected through random selection method. From each selected village 25 respondents were selected through purposive sampling technique; who fall under the specific criteria i.e. the mothers aged from 15-49 years having their last baby more than 6 months and less than five years old. Size of sample (600) was fixed using equal allocation method. A well-structured interview schedule about antenatal and postnatal services was designed for this purpose. The data thus, collected were fed to computer for analysis. Univeriate, bivariate and multivariate statistical methods were used for data analysis. It was found that a huge majority of the respondents had knowledge about the antenatal (97.3 percent) and postnatal (97 percent) care services and their source of information were LHWs and TBAs. A huge majority of the respondents (87.2 percent) reported that medical health facilities were available in their area. A substantial proportion of the respondents went to antenatal services due to illness, to check the well being of the fetus and immunization of themselves. More than a half of them visited antenatal care center because of complications during child birth. A majority of the respondents (72.5 percent) reported that they called a midwife at home for any service, 48.3 percent of the respondents delivered their baby at home, while 45.0 percent of them delivered their baby at a hospital in the sampled area. Education level of mothers and their husbands, family income, awareness and availability of antenatal services have positive and significant association with the utilization of antenatal services, whereas, influence of culture, cost of antenatal services, distance from health facility, age of the respondents and total live births had negative association with the utilization of antenatal services. Similarly education level of the respondents and their husbands, family income and availability of postnatal services have positive and significant association with the utilization of postnatal services. Influence of culture, distance of health care facilities and cost of postnatal services have negative and significant association with the utilization of postnatal services. A comprehensive training program should be designed at government level to train LHWs and TBAs to improve their knowledge and practice because a huge majority of rural women rely on them for information about antenatal and postnatal services.