Magnitude of Early Discharge from Immediate Postnatal Care, Its Associated Factors, and Barriers Among Mothers Who Delivered at Health Facilities in Dabat District, Northwest Ethiopia, 2023: A Mixed Methods Approach

Abstract

Background፡ Immediate postnatal care plays a vital role in ensuring the health and well-being of both mothers and newborns. However, early discharge from postnatal care remains a significant challenge in many low-resource settings, including Dabat, Northwest Ethiopia. Objective፡ This study aimed to assess the magnitude of early discharge from immediate postnatal care, its associated factors, and explore barriers among mothers who gave birth in health facilities in Dabat District, Northwest Ethiopia, 2023. Methods፡ A community-based cross-sectional study supplemented with phenomenological concurrent parallel mixed methods design was conducted in Dabat district from March 1, 2023 to March 30, 2024. A total of 384 women who gave birth at health facilities were selected through simple random sampling technique using lottery method. Data was entered using Epi data V.4.6 and STATA V.14 was employed for analysis. Bi-variable and multivariable logistic regression analyses were employed. Finally, variables with p-value <0.05 with 95% CI were considered as statistically significant. Model fitness and multicollinearity was also done. Key informant interviews and in-depth interviews were conducted and the sample size was determined based on saturation of information. Data were transcribed in Amharic, and translated into English, then coded and reduced by interpretive thematic analysis using Open Code V 4. 02.. Results: The magnitude of early discharge from immediate postnatal care was 73.23% (95% CI: 68.53, 77.45). Multivariable logistic regression analysis identified being unable to read and write (AOR= 2.92, 95% CI: 1.09-7.81), rural residence (AOR= 2.23, 95% CI: 1.08-4.56), being a housewife (AOR= 1.88, 95% CI: 1.02-3.47), insufficient antenatal care visits (AOR= 3.75, 95% CI: 1.67-8.47), lack of postnatal care information (AOR= 2.81, 95% CI: 1.14-6.90), and lack of support from healthcare providers, (AOR= 1.89, 95% CI: 1.61-4.31) as significant factors. Qualitative analysis explored barriers such as poor awareness, traditional beliefs, lack of social support, and issues with healthcare provider ethics affecting immediate postnatal care. Conclusion: The study revealed a higher rate of early discharge from immediate postnatal care compared to previous studies. Factors contributing to this included unable to read and write, rural residence, being a housewife, insufficient antenatal care visits, lack of support from healthcare providers were identified as significant factors. Barriers such as poor awareness, traditional beliefs, lack social support and issues with healthcare provider ethics also played a role. Addressing these challenges is crucial for improving maternal and child health outcomes in the setting