Abstract of Dissertation

Agency : Postnatal Care, Rural Health, Utilization of Postnatal Care, Factors Determining

Objective : To assess the level of utilization of postnatal care services in rural areas of Bathanaha block dist. Sitamarhi, Bihar To identify the critical factors affecting the utilization of postnatal care services in rural areas of Bathanaha block dist. Sitamarhi, Bihar

Background : Postnatal care is essential to save the life of the mother and newborn. Knowledge on the determinants of postnatal care assists the policy makers to design, justify and implement appropriate interventions. The current study aimed to analyse the critical factors determining utilisation of postnatal care services by mothers in rural areas of district Sitamarhi, Bihar. The MMR in Bihar is 294 per 100,000 (AHS, 2012) live births whereas the IMR is 43 per 1000 live births (SRS, 2013). Sitamarhi is also a higher priority district for the intervention of RMNCHA+.

Methodology : This was a retrospective population based study undertaken in 11 rural villages of the Sitamarhi district, Bihar. The data was collected from a sample of 100 drawn from mothers who delivered within 3 months. The study population was selected by using a combination of probability sampling (simple random sampling) and Non probability sampling (purposive) techniques. One dependent variable was used in the analysis: The PNC was measured by whether a woman received first PNC visit or not. Household and women's characteristics were used as explanatory variables for the dependent variables.

Findings : Of the 100 mothers, 81 mothers reported attending postnatal care within 24 hours of the childbirth, but when they were further interviewed, the study revealed that only 15 percent of mothers out of 81 received actual PNC visit. This was analysed on the basis of whether they were being asked/checked for heavy bleeding as dangerous symptom for mothers after birth before leaving the hospital. More than half of the mothers who delivered at facility were discharged within few hours after delivery on the same day. Only 12 percent of the total respondents were aware of heavy bleeding, fever, pain in abdomen as dangerous symptoms after delivery. Only 4 mothers out of 77 mothers who delivered at facility hads utilized Jannani express, whereas 81 mothers out of 100 belong to B.P.L. 65 percent of the mothers were uneducated. 84 percent of the all mothers interviewed got married in the age group 15-19 and 46 percent of the all mothers interviewed had their first conception in the same age group. Out of 100 mothers only 32 mothers were aware of PNC. Only 31 percent of the mothers received HPV-0 vaccine for their child at birth whereas BCG was received by 73 percent of the respondents. Only 62 percent of the mothers had received at least one dose of TT vaccination during their pregnancy. The mothers who breast fed their baby within one hour were only 61 percent and the mothers who knew about kangaroo care were only 14 percent.

Recommendations : Research findings have revealed that percentage of utilization of postnatal care services in the rural areas of Bathanaha block, Sitamarhi dist, Bihar is only 12 percent. And the study also revealed that age at birth of mothers, mothers’ education, place of delivery, attendance of ANC and parity all have a significant influence on the utilization of postpartum care services. It can therefore be deduced that expectant mothers mainly require sufficient knowledge about the use of postpartum services if they are to have healthy babies.