The Determinants of Postnatal Health Check Providers in Sierra Leone: Insight from the 2019 SLDHS

Abstract

Philomene Nsengiyumva and Palesa Patience Moloi

Introduction: Maternal and neonatal outcomes are critically influenced by the quality of postnatal care. Despite efforts to improve maternal healthcare utilization in Sierra Leone, significant disparities persist in access to professional postnatal care. This study examines the factors associated with the type of healthcare providers performing postnatal check-ups among mothers.

Methods: This study used data from the 2019 Sierra Leone Demographic and Health Survey (SLDHS). Of the 7323 women who gave birth in the five years preceding the survey, 3403 women aged between 15 and 49 years provided information on whether their postnatal check-ups were conducted by a doctor, nurse/midwife, auxiliary midwife, traditional birth attendant, community/village health worker, or another provider. Descriptive statistics, Chi-square test and multinomial logistic regression techniques were used to analyse the data by using the IBM SPSS version 29 software platform.

Chi-square tests revealed that region (χ2=169.349, p=0.001); place of residence (χ2=90.723, p=0.001); level of education (χ2=29.253, p=0.0253); wealth index (χ2=107.884, p=0.001); working status (χ2=23.667, p=0.001); and birth order (χ2=19.022, p=0.04) were associated with postnatal health providers. Multinomial logistic regression analysis revealed that age (women aged 30-34, OR=1.491; 35-39, OR=1.566; 40-44, OR=1.585), region of residence (Eastern, OR=2.833; Northern, OR=3.512; North Western, OR=2.269; Southern, OR=2.842), place of residence (urban, OR=1.209), wealth index (poorest, OR=1.466; poorer, OR=1.527; middle, OR=1.788), place of delivery (government health centre, OR=1.371; private hospital/clinic, OR=3.952), marital status (living with a partner, OR=1.991) and birth order (0-4, OR=0.687; 5-9, OR=0.547) influenced postnatal health check providers in Sierra Leone. Conversely, determinants for non-professional care showed inverse trends.

Conclusion: These findings highlight significant socioeconomic and geographical inequities in postnatal care access, underscoring the need for targeted interventions to improve healthcare infrastructure, promote facility-based deliveries, and enhance maternal health education.

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