Factors influencing utilization of day six postnatal care services among mothers attending health facilities in Nwoya district, Northern Uganda

Abstract

Introduction: Utilization of Day Six Postnatal Care (PNC) services is essential for early detection and management of maternal and neonatal complications within the first week after delivery. However, uptake of these services remains low in many low-resource settings, including Uganda. Utilization is influenced by individual, obstetric, and health system factors. This study aimed to determine the factors influencing utilization of Day Six postnatal care services among mothers attending health facilities in Nwoya District, Northern Uganda. Methods: A facility-based cross-sectional study design using a quantitative approach was employed. Data were collected from conveniently selected postpartum mothers attending YCC in two selected health facilities of Anaka Hospital and Alero Health Centre III using structured questionnaires. A total of 461 respondents were included in the study. Data were analyzed using SPSS version 26. Descriptive statistics summarized the data, while bivariate and multivariable logistic regression analyses were used to determine factors associated with utilization of Day Six postnatal care services. Results were presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI), and findings were presented in tables and text. Results: The uptake of Day Six postnatal care services was low, with only 23.2% of mothers attending the service, while 76.8% did not utilize it. Utilization was significantly associated with several factors. Mothers with secondary education and above were more likely to utilize Day Six postnatal care compared to those with no formal education (AOR = 3.52; 95% CI: 1.41–8.78; p = 0.007). Urban residence was associated with higher utilization compared to rural residence (AOR = 2.24; 95% CI: 1.26–3.98; p = 0.006). Mothers who attended antenatal care during their last pregnancy were more likely to utilize Day Six postnatal care compared to those who did not attend ANC (AOR = 2.41; 95% CI: 1.18–4.92; p = 0.015). Facility delivery was positively associated with utilization compared to home delivery (AOR = 0.38; 95% CI: 0.18–0.78; p = 0.009). Other significant predictors included caesarean section delivery, premature birth, shorter distance to health facilities, childbirth complications, positive provider attitude, and receipt of adequate information during care. Conclusion: The utilization of Day Six postnatal care services in Nwoya District was low and was influenced by individual factors (education and residence), obstetric factors (ANC attendance, mode of delivery, birth outcomes, and complications), and health system factors (distance to facility, provider attitude, and information provision). Strengthening maternal health education, improving access to services, enhancing quality of care, and promoting continuity of care from ANC through delivery and postnatal periods are essential to improve uptake of Day Six postnatal care services.