TABLE OF CONTENTS
DECLARATION ............................................................................................................................ ii
APPROVAL ..................................................................................................................................iii
DEDICATION............................................................................................................................... iv
ACKNOWLEDGEMENT.............................................................................................................. v
TABLE OF CONTENTS............................................................................................................... vi
LIST OF FIGURES ........................................................................................................................ x
LIST OF TABLES......................................................................................................................... xi
LIST OF ABBREVIATIONS AND ACRONYMS ..................................................................... xii
DEFINITION OF TERMS ..........................................................................................................xiii
ABSTRACT................................................................................................................................. xiv
CHAPTER ONE............................................................................................................................. 1
INRODUCTION............................................................................................................................. 1
1.0 Introduction............................................................................................................................... 1
1.1 Background to the study ........................................................................................................... 1
1.2 Statement of the Problem.......................................................................................................... 3
1.3 General Objective/Aim of the study ......................................................................................... 3
1.3.1 Specific objectives................................................................................................................. 3
1.3.2 Research questions................................................................................................................. 4
1.4 Significance of the study........................................................................................................... 4
1.5 Scope of the study..................................................................................................................... 4
CHAPTER TWO ............................................................................................................................ 5
LITERATURE REVIEW ............................................................................................................... 5
2.0 Introduction............................................................................................................................... 5
2.1 General introduction to the role of PNCin Maternal Child health services.............................. 5
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2.2 Socio-demographic factors affecting Post-natal care ............................................................... 6
2.3 Health system factors affecting utilization of PNC .................................................................. 8
2.4 Summary................................................................................................................................... 9
CHAPTER THREE ...................................................................................................................... 10
METHODOLOGY ....................................................................................................................... 10
3.0 Introduction............................................................................................................................. 10
3.1 Study design............................................................................................................................ 10
3.2 Study population ..................................................................................................................... 10
3.3 Sample size determination ...................................................................................................... 10
3.4 Sampling Procedure and rationale .......................................................................................... 10
3.5 Data collection tools ............................................................................................................... 11
3.6 Data collection procedure/method .......................................................................................... 11
3.7 Piloting the study .................................................................................................................... 11
3.8 Inclusion and exclusion criteria .............................................................................................. 11
3.8.1 Inclusion criteria .................................................................................................................. 11
3.8.2 Exclusion criteria ................................................................................................................. 12
3.9 Data Analysis and presentation............................................................................................... 12
3.10 Ethical consideration............................................................................................................. 12
3.11 Limitations for the study....................................................................................................... 13
3.12 Dissemination of results........................................................................................................ 13
CHAPTER FOUR......................................................................................................................... 14
RESULTS ..................................................................................................................................... 14
4.0 Introduction............................................................................................................................. 14
4.1 Demographic characteristics of the respondents..................................................................... 14
4.2 Utilization of PNC services .................................................................................................... 15
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4.2.1 Uptake of PNC care services ............................................................................................... 15
4.2.2 Timing of the first PNC visit ............................................................................................... 16
4.2.3 Reasons for attending PNC services.................................................................................... 17
4.2.4 Reasons for not attending PNC services.............................................................................. 18
4.3 Socio-demographic factors influencing utilization of PNC services...................................... 19
4.3.1 Association between age and PNC utilization..................................................................... 19
4.3.2 Association between education status and PNC service utilization..................................... 19
4.3.3 Association between religion and PNC utilization .............................................................. 20
4.3.4 Association of marital status and PNC utilization ............................................................... 20
4.3.5 Association of parity and PNC utilization ........................................................................... 21
4.3.6 Association between Employment status and PNC services............................................... 21
4.3.7 Association between spouse’s education and PNC utilization ............................................ 22
4.3.8 Association between wealth status and PNC utilization...................................................... 22
4.4 Health system factors.............................................................................................................. 23
4.4.1 Association between distance to the health facility and PNC utilisation............................. 23
4.4.2 Association between mode of transport to the health facility and PNC utilisation. ............ 23
4.4.3 Association between place of delivery and utilization of PNC services ............................. 23
4.4.4 Association between 4th ANC visit and Utilisation of PNC services.................................. 24
4.4.5 Quality of care and utilisation of PNC services................................................................. 25
4.4.5.1 Quality of care studied...................................................................................................... 25
4.5 Women’s knowledge about PNC services.............................................................................. 25
CHAPTER FIVE .......................................................................................................................... 27
DISCUSSION, CONCLUSION AND RECOMMENDATIONS................................................ 27
5.0 Introduction............................................................................................................................. 27
5.1 Discussion............................................................................................................................... 27
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5.1.1 Introduction.......................................................................................................................... 27
5.1.2 Utilization of PNC services ................................................................................................. 27
5.1.3 Socio-Demographic Determinants of PNC Utilization........................................................ 27
5.1.4 Health system factors associated with PNC utilization ...................................................... 28
5.1.5 Knowledge about and attitude towards Utilization of PNC utilization. .............................. 29
5.2 Conclusion ............................................................................................................................. 30
5.3 Recommendations................................................................................................................... 30
REFERENCIES ............................................................................................................................ 31
APPENDIX ONE: QUESTIONNAIRE ....................................................................................... 33
APPENDIX II: KEY INFORMANT INTERVIEW GUIDE ....................................................... 38
APPENDIX III: A map of Uganda showing location of Mitooma District.................................. 40
APPENDIX IV: MAP OF MITOOMA DISTRICT SHOWING SUBCOUNTIES..................... 41
APPENDIX V: MORGAN’S TABLE.......................................................................................... 42
ABSTRACT The study assessed factors that influence the utilization of PNC services by mothers at Kabira HCIII in Mitooma district. The objectives of the study were to identify socio-demographic factors influence utilization of postnatal care services, to find out client factors influence utilization of PNC services and to determine the health system factors influence the utilization of PNC services by mothers at Kabira HCIII in Mitooma district. The survey was a descriptive cross sectional study where by women in child bearing age attending MCH clinics at Kabira Health Centre III in Mitooma district as well as health workers of Kabira Health Centre III and while using Morgan’s table, a sample size of 148 were recruited. The study found out that utilization of postnatal care in the study area was (55.6%). The services were mainly accessed at or after 6 weeks. The socio-demographic determinants that were found to be predictive of utilization of PNC services were level of education, household wealth status, and employment status. Health systems associated with PNC services were quality of care and delivery in a government facility, knowledge of PNC services and a positive attitude were also predictive of utilization of PNC services In conclusion, although there are some programs by ministry of health to help and extend postnatal services to mothers, more interventions need to be done to improve access of PNC services by women and the following were recommendations made. The MOH needs to sensitize the communities on the importance of PNC services, the health care workers need to inform the clients about PNC service and schedule appointments and also the quality of services in the facility needs to be improved and be responsive to the users
