Background
Methods
Outcome variables
Independent variables
Statistical analysis
Result
Characteristics of respondents
Factor | Total | Attended postnatal care | Attended immediate postnatal care |
---|---|---|---|
N (%) | n (%)#
| n (%)#
| |
Proximate factors
| |||
Mother’s age (in years)
| P < 0.001* | P < 0.001* | |
15-19 | 306 (7.5) | 161 (51.6) | 153 (48.9) |
20-29 | 2608 (63.9) | 1227 (46.0) | 1164 (43.8) |
30-34 | 661 (16.2) | 270 (39.9) | 259 (38.2) |
> = 35 | 504 (12.4) | 130 (7.7) | 118 (24.3) |
Number of ANC visits
| P < 0.001* | P < 0.001* | |
No ANC visit | 611 (15.0) | 65 (11.5) | 59 (10.4) |
1-3 | 1317 (32.3) | 383 (27.9) | 355 (25.9) |
4 or more | 2151 (52.7) | 1340 (63.3) | 1280(60.6) |
Timing of ANC
| P < 0.001* | P < 0.001* | |
Late ANC (4–9 months) | 2018 (49.5) | 607 (30.0) | 509 (35.7) |
Early ANC (<=3 months) | 2061 (50.5) | 1181(56.5) | 1126 (53.9) |
Place of delivery
| P < 0.001* | P < 0.001* | |
Home | 2464 (60.4) | 339 (14.3) | 281 (11.7) |
Health facility | 1615 (39.6) | 1449 (89.2) | 1413 (87.6) |
Attendance during delivery
| P < 0.001* | P < 0.001* | |
Unskilled attendance | 2236 (54.8) | 208 (9.8) | 155 (7.2) |
Skilled attendance | 1843 (45.2) | 1580 (83.9) | 1539 (82.2) |
Maternal final say on her own health care
| P < 0.001* | P < 0.001* | |
Women with partner/other | 1522 (37.7) | 737 (47.7) | 707 (45.7) |
Women alone | 917 (22.7) | 419 (44.7) | 402 (43.0) |
Partner alone/someone else | 1594 (39.5) | 616 (38.2) | 571 (35.5) |
Birth order
| P < 0.001* | P < 0.001* | |
First | 1248 (30.6) | 770 (61.8) | 733 (59.7) |
Second or third | 1847 (45.3) | 802 (41.2) | 758 (38.4) |
Fourth or more | 948 (24.1) | 216 (21.6) | 203 (20.3) |
Sex of child
| P = 0.209 | P = 0.305 | |
Male | 2192 (53.7) | 946 (42.0) | 902 (39.9) |
Female | 1887 (46.3) | 842 (44.5) | 792 (42.0) |
Sociodemographic factors
| |||
Wealth status
| P < 0.001* | P < 0.001* | |
Poor (Lower 40%) | 1992 (48.8) | 493 (23.8) | 458 (22.2) |
Middle (Middle 40%) | 1416 (34.7) | 756 (50.6) | 723 (48.0) |
Rich (Upper 20%) | 671 (16.5) | 539 (80.7) | 213 (77.4) |
Ethnicity
| P < 0.001* | P < 0.001* | |
Advantaged | 1955 (47.9) | 971 (51.4) | 921 (48.9) |
Disadvantaged (Janjati) | 1410 (34.6) | 549 (37.4) | 515 (35.2) |
Disadvantaged (Dalit) | 714 (17.5) | 268 (35.0) | 258 (33.5) |
Religion
| P = 0.008* | P = 0.014* | |
Hindu | 3480 (85.3) | 1575 (44.9) | 1491 (42.5) |
Others | 599 (14.7) | 213 (34.8) | 203 (33.3) |
Maternal education
| P < 0.001* | P < 0.001* | |
No education | 1765 (43.3) | 449 (26.6) | 418 (24.7) |
Primary | 817 (20.0) | 341 (39.8) | 322 (37.8) |
Secondary | 1225 (30.0) | 760 (61.0) | 728 (58.7) |
Higher | 272 (6.7) | 238 (85.5) | 226 (80.8) |
Maternal occupation
| P < 0.001* | P < 0.001* | |
Not working | 965 (23.7) | 603 (59.5) | 571 (56.6) |
Agriculture | 2502 (61.3) | 797 (31.0) | 757 (29.4) |
Working (paid) | 612 (15.0) | 388 (61.3) | 366 (57.8) |
Paternal education
| P < 0.001* | P < 0.001* | |
No education | 761 (18.7) | 176 (24.2) | 161 (22.3) |
Primary | 989 (24.2) | 313 (32.3) | 297 (30.2) |
Secondary | 1815 (44.5) | 921 (50.4) | 879 (48.1) |
Higher | 514 (12.6) | 378 (74.7) | 357 (71.8) |
Paternal occupation
| P < 0.001* | P < 0.001* | |
Agriculture | 978 (24.0) | 253 (26.0) | 237 (24.4) |
Professional/technical | 1715 (42.0) | 1012 (58.3) | 961 (55.5) |
Manual and others | 1386 (34.0) | 523 (37.4) | 496 (35.5) |
Community factors
| |||
Place of residence
| P < 0.001* | P < 0.001* | |
Urban | 897 (22.0) | 610 (71.8) | 579 (68.2) |
Rural | 3182 (78.0) | 1178 (39.9) | 1115 (37.9) |
Development region
| P = 0.692 | P = 0.725 | |
Eastern | 958 (23.5) | 405 (46.0) | 375 (42.9) |
Central | 854 (20.9) | 381 (42.7) | 364 (40.6) |
Western | 643 (15.8) | 333 (44.4) | 322 (43.1) |
Mid -western | 896 (22.0) | 359 (38.5) | 342 (36.5) |
Far-western | 728 (17.8) | 310 (42.4) | 291 (39.2) |
Ecological region
| P < 0.001* | P < 0.001* | |
Mountain | 742 (18.2) | 208 (26.7) | 195 (24.9) |
Hill | 1656 (40.6) | 663 (37.6) | 628 (35.8) |
Terai | 1681 (41.2) | 917 (49.8) | 871 (47.1) |
Utilisation of postnatal care
Factors associated with postnatal care attendance
Factor | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | ||
---|---|---|---|---|
Model 1 | Model 2 | Model 3 | ||
Community factors
| ||||
Place of residence
| P < 0.001 | P < 0.001 | P < 0.001 | P = 0.593 |
Rural | 1.00 | 1.00 | 1.00 | 1.00 |
Urban | 3.835 (2.971-4.950) | 3.953 (2.992-5.222) | 1.574 (1.196-2.072) | 0.897 (0.603-1.336) |
Ecological region
| P < 0.001 | P < 0.001 | P < 0.017 | P = 0.477 |
Mountain | 1.00 | 1.00 | 1.00 | 1.00 |
Hill | 1.648 (1.095-2.482) | 1.422 (0.935-2.161) | 1.007 (0.694-1.459) | 0.898 (0.628-1.268) |
Terai | 2.713 (1.854-3.971) | 2.498 (1.700-3.669) | 1.469 (0.997-2.165) | 1.374 (0.945-1.997) |
Sociodemographicfactors
| ||||
Wealth status
| P < 0.001 | P < 0.001 | P = 0.018 | |
Poor (Lower 40%) | 1.00 | 1.00 | 1.00 | |
Middle (Middle 40%) | 2.489 (1.958-3.166) | 1.638 (1.260-2.129) | 1.452 (1.094-1.928) | |
Rich (Upper 20%) | 7.055 (5.469-9.056) | 3.182 (2.171-4.665) | 1.794 (1.103-2.917) | |
Ethnicity
| P < 0.001 | P = 0.735 | Not in model | |
Advantaged | 1.00 | 1.00 | ||
Disadvantaged (Janjati) | 0.566 (0.441-0.726) | 0.921 (0.690-1.228) | ||
Disadvantaged (Dalit) | 0.509 (0.407-0.636) | 1.037 (0.808-1.332) | ||
Religion
| P = 0.008 | P = 0.170 | Not in model | |
Hindu | 1.525 (1.115-2.086) | 1.263 (0.899-1.774) | ||
Others | 1.00 | 1.00 | ||
Maternal education
| P < 0.001 | P < 0.001 | P = 0.049 | |
No education | 1.00 | 1.00 | 1.00 | |
Primary | 1.826 (1.453-2.296) | 1.469 (1.180-1.828) | 1.092 (0.809-1.476) | |
Secondary | 4.320 (3.402-5.482) | 2.279 (1.754-2.961) | 1.153 (0.823-0.823) | |
Higher | 16.247 (10.309-25.605) | 4.623 (2.880-7.421) | 2.257 (1.193-4.267) | |
Maternal occupation
| P < 0.001 | P = 0.002 | P = 0.462 | |
Not working | 1.00 | 1.00 | 1.00 | |
Agriculture | 0.305 (0.237-0.394) | 0.623 (0.481-0.807) | 0.864 (0.602-1.241) | |
Working (paid) | 1.077 (0.791-1.466) | 0.782 (0.578-1.052) | 0.749 (0.471-1.193) | |
Paternal education
| P < 0.001 | p = 0.042 | P = 0.862 | |
No education | 1.00 | 1.00 | 1.00 | |
Primary | 1.497 (1.105-2.028) | 1.266 (0.967-1.657) | 1.064 (0.754-1.504) | |
Secondary | 3.194 (2.394-4.262) | 1.489 (1.129-1.965) | 1.146 (0.804-1.635) | |
Higher | 9.244 (6.155-13.887) | 1.736 (1.099-2.742) | 1.257 (0.665-2.378) | |
Paternal occupation
| P < 0.001 | P < 0.001 | P = 0.768 | |
Agriculture | 1.00 | 1.00 | 1.00 | |
Professional/Technical | 3.990 (3.147-5.059) | 1.718 (1.354-2.179) | 1.099 (0.851-1.421) | |
Manual and others | 1.704 (1.350-2.151) | 1.398 (1.102-1.772) | 1.095 (0.578-2.074) | |
Proximate factors
| ||||
Mother’s age (in years)
| P < 0.001 | P = 0.294 | ||
15-19 | 1.00 | 1.00 | ||
20-29 | 0.800 (0.603-1.061) | 1.321 (0.858-2.035) | ||
30-34 | 0.624 (0.452-0.860) | 1.420 (0.835-2.416) | ||
> = 35 | 0.348 (0.246-0.494) | 1.580 (0.989-2.524) | ||
Number of ANC visits
| P < 0.001 | P < 0.001 | ||
No ANC visit | 1.00 | 1.00 | ||
1-3 | 2.983 (1.983-4.487) | 1.597 (1.083-2.355) | ||
4 or more | 13.323 (8.570-20.711) | 3.624 (2.343-5.604) | ||
Place of delivery
| P < 0.001 | P = <0.001 | ||
Home | 1.00 | 1.00 | ||
Health facility | 49.739 (36.179-68.348) | 31.084 (22.416-43.106) | ||
Maternal final say on her own health care
| P = 0.001 | P = 0.587 | ||
Women alone | 1.00 | 1.00 | ||
Women with partner/other | 1.131 (0.910-1.405) | 1.143 (0.855-1.530) | ||
Partner alone/someone else | 0.765 (0.605-0.966) | 1.084 (0.801-1.468) |
Factor associated with immediate postnatal care attendance
Factor | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | ||
---|---|---|---|---|
Model 1 | Model 2 | Model 3 | ||
Community factors
| ||||
Place of residence
| P < 0.001 | P < 0.001 | P = 0.006 | P = 0.227 |
Rural | 1.00 | 1.00 | 1.00 | 1.00 |
Urban | 3.511 (2.714-4.511) | 3.539 (2.725-4.739) | 1.464 (1.116-1.921) | 0.777 (0.515-1.171) |
Ecological region
| P < 0.001 | P < 0.001 | P = 0.026 | P = 0.086 |
Mountain | 1.00 | 1.00 | 1.00 | 1.00 |
Hill | 1.682 (1.114-2.539) | 1.461 (0.960-2.223) | 1.047 (0.723-1.517) | 0.939 (0.668-1.321) |
Terai | 2.684 (1.828-3.941) | 2.474 (1.680-3.647) | 1.473 (1.001-2.171) | 1.313 (0.921-1.873) |
Sociodemographic factors
| ||||
Wealth status
| P < 0.001 | P < 0.001 | P = 0.001 | |
Poor (Lower 40%) | 1.00 | 1.00 | 1.00 | |
Middle (Middle 40%) | 2.543 (2.009-3.219) | 1.663 (1.272-2.174) | 1.670 (1.111-2.512) | |
Rich (Upper 20%) | 6.609 (5.143-8.843) | 3.068 (2.106-4.470) | 3.693 (2.319-5.880) | |
Ethnicity
| P < 0.001 | P = 0.0519 | Not in model | |
Advantaged | 1.00 | 1.00 | ||
Disadvantaged (Janjati) | 0.566 (0.443-0.723) | 0.888 (0.677-1.166) | ||
Disadvantaged (Dalit) | 0.526 (0.420-0.657) | 1.076 (0.832-1.392) | ||
Religion
| P = 0.014 | P = 0.350 | Not in model | |
Hindu | 1.477 (1.081-2.017) | 1.167 (0.844-1.613) | ||
Others | 1.00 | 1.00 | ||
Maternal education
| P < 0.001 | P < 0.001 | P = 0.502 | |
No education | 1.00 | 1.00 | 1.00 | |
Primary | 1.852 (1.477-2.323) | 1.483 (1.193-1.843) | 1.141 (0.825-1.576) | |
Secondary | 4.333 (3.436-5.464) | 2.287 (1.789-2.923) | 1.189 (0.849-1.665) | |
Higher | 12.824 (8.404-19.567) | 3.657(2.273-5.882) | 1.563 (0.819-2.982) | |
Maternal occupation
| P < 0.001 | P < 0.002 | P = 0.396 | |
Not working | 1.00 | 1.00 | 1.000 | |
Agriculture | 0.318 (0.252-0.402) | 0.644 (0.506-0.819) | 0.936 (0.661-1.326) | |
Working (paid) | 1.049 (0.784-1.403) | 0.776 (0.586-1.027) | 0.730 (0.458-1.164) | |
Paternal education
| P < 0.001 | P = 0.036 | P = 0.781 | |
No education | 1.00 | 1.00 | 1.00 | |
Primary | 1.509 (1.101-2.069) | 1.272 (0.953-1.699) | 1.044 (0.717-1.520) | |
Secondary | 3.229 (2.390-4.363) | 1.521 (1.134-2.038) | 1.150 (0.812-1.628) | |
Higher | 8.854 (5.886-13.321) | 1.817 (1.123-2.939) | 1.293 (0.963-2.403) | |
Paternal occupation
| P < 0.001 | P < 0.001 | P = 0.890 | |
Agriculture | 1.00 | 1.00 | 1.00 | |
Professional/technical | 3.856 (3.039-4.892) | 1.677 (1.302-2.160) | 1.070 (0.812-1.411) | |
Manual and others | 1.699 (1.343-2.150) | 1.396 (1.101-1.769) | 1.062 (0.553-2.040) | |
Proximate factors | ||||
Mother’s age (in years)
| P < 0.001 | P = 0.350 | ||
15-19 | 1.00 | 1.00 | ||
20-29 | 0.816 (0.619-1.077) | 1.426 (0.941-2.161) | ||
30-34 | 0.646 (0.472-0.884) | 1.568 (0.925-2.658) | ||
> = 35 | 0.335 (0.239-0.471) | 1.399 (0.883-2.217) | ||
Number of ANC visits
| P < 0.001 | P < 0.001 | ||
No ANC visit | 1.00 | 1.00 | ||
1-3 | 3.019 (1.934-4.712) | 1.670 (1.111-2.512) | ||
4 or more | 13.325 (8.274-21.457) | 3.693 (2.319-5.880) | ||
Place of delivery
| P < 0.001 | P < 0.001 | ||
Home | 1.00 | 1.00 | ||
Health facility | 52.920 (38.559-72.630) | 34.894 (24.956-48.789) | ||
Maternal final say on her own health care
| P < 0.001 | P = 0.665 | ||
Women alone | 1.00 | 1.00 | ||
Women with partner/other | 1.114 (0.898-1.381) | 1.082 (0.783-1.495) | ||
Partner alone/someone else | 0.729 (0.575-0.923) | 0.940 (0.961-1.278) |