Coverage and determinants of postnatal care in Nigeria: A pediatric investigation study

Neonatal deaths are a serious issue in Nigeria. More than a quarter million infants die every year and 700 infants every day in Nigeria. Most of the infant deaths are known to occur during the early neonatal period (first week of life). Some of the major causes behind such high mortality include preterm births, infections, and congenital diseases.

To reduce infant deaths within the first week of life, the WHO has recommended infant PNC, that is, regular medical visits for the first six weeks after birth. It encompasses comprehensive care for infants such as immunization, counseling for mothers, encouraging skin-to-skin contact between the mother and the baby, breastfeeding, and pediatric checkups. Although WHO reiterates its importance, the utilization of PNC remains low.

A team of researchers led by Dr. Bolaji Emmanuel Egbewale from the Department of Global Health and Population, Harvard University, U.S., and Department of Community Medicine, Ladoke Akintola University of Technology, Nigeria, conducted a population-based cross-sectional study to report the extent of infant PNC care in Nigeria and the factors that determine the likelihood of receiving PNC.

Dr. Olusola Oyedeji from Department of Pediatrics and Child Health at Ladoke Akintola University of Technology in Nigeria, and Dr. Jesse Bump and Dr. Christopher Robert Sudfeld from the Department of Global Health and Population at Harvard University, U.S., were also involved in the research and served as co-authors in the study, which was published in the journal Pediatric Investigation.

The researchers used data from the 2018 Nigeria Demographic Health Survey (NDHS) to assess the national PNC coverage and the factors influencing access to PNC. "We included only the data of children born two years before the 2018 NDHS and employed statistical analysis to evaluate the coverage and determinants of infant PNC," says Dr. Egbewale.

The findings reveal that the national coverage of infants receiving PNC within two days of birth was as low as 37.3%. At the population-level, the PNC coverage varied significantly among the states and regions. For instance, states in Southwest regions had more PNC coverage compared to states in Northwest region.

"We discovered the individual-level factors such as greater maternal education, maternal employment, having an urban residence, having a female head of household, and greater wealth were associated with the increased uptake of PNC. In addition, we identified facility delivery as a factor that strongly influenced mothers to seek infant PNC," explains Dr. Egbewale.

Moreover, the association of maternal education with PNC utilization can be explained by the fact that mothers with high level of education are well versed with the importance of PNC and being employed provides financial support and access to health care services. Furthermore, urban areas have more delivery facilities than rural areas which makes health care services like PNC easily accessible.

"The findings of our study highlight the need for further research and development of interventions encouraging women to seek infant PNC while considering the factors such as knowledge and access barriers; thereby, promoting the uptake of PNC in Nigeria. Thus, our study marks a step towards the goal of reducing infant mortality globally," concludes Dr. Egbewale.