Factors influencing utilization of postnatal care services among postpartum mothers of Vijayanagara district,Karnataka, India

Factors influencing utilization of postnatal care services among postpartum mothers of Vijayanagara district,Karnataka, India | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors influencing utilization of postnatal care services among postpartum mothers of Vijayanagara district,Karnataka, India Sunitha N H, Vinutha Muktamath This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4226105/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 17 You are reading this latest preprint version Abstract India has made tremendous progress in reducing MMR by 92 per cent since 2020, but still efforts are required to achieve the new SDG target. Vijayanagara district of Karnataka is a district of Kalyan Karnataka with poor maternal and infant health practices according to National family health survey V report. Hence the present study was conducted with the objective to assess the utilization of post-natal services (PNC) and study the factors influencing utilization of postnatal care services. A community based cross sectional study was conducted in the year 2021-23 in Vijayanagar district on a sample of 810 mothers within 3 months of delivery. Pre-tested questionnaire was used to elicit the information on utilization of postnatal care services and demographic information. SES scale by Agarwala et al . 2005 was used. Data was analyzed using SPSS package Version 26. Results revealed that the overall prevalence of utilization of postnatal care services was 32.46 per cent out of 810 mothers. Mothers between 29 to 32 years had utilized postnatal care services, mothers from middle SES (46.50 %) group, who had ANC attendance, who had knowledge on PNC services (36.30 %) were utilized all the recommended PNC services. Socioeconomic status, age of mother, number of ANC visits and knowledge on postnatal care services were found to be significant factors affecting postnatal care services utilization. The study revealed low level of utilization of postnatal care services among mother (32.46 %). This emphasizes the need to educate pregnant and lactating mothers regarding the importance of PNC services. Postnatal care services Utilization Socio-economic status antenatal visits and prevalence. Figures Figure 1 Introduction In a respectful atmosphere, pregnancy, childbirth, and parenting can effectively uphold women's rights and social standing without compromising their health. Safe motherhood and childbirth are made possible by the support that communities and families give expectant mothers and their newborns, the expertise of medical professionals, and the availability of sufficient medical facilities, supplies and emergency care when needed [ 13 ]. Over 500,000 women worldwide lose their lives during or shortly after giving birth to children each year; over 90 per cent of these deaths take place in underdeveloped nations [ 3 ]. The postnatal phase lasts six weeks from the time a baby is delivered until the reproductive organs revert to their typical non-pregnant state [ 8 ]. For the well being of both the mother and the child, the timing of postnatal care is equally essential. Studies have indicated that the "immediate postnatal period," which lasts for 24 hours following delivery, accounts for 50% of maternal mortality and 40% of neonatal deaths. The World Health Organization advises women who give birth in a medical facility to get PNC for at least 24 hours following the birth. The first postnatal visit should happen as soon as after delivery—ideally within 24 hours—if the birth takes place at home. It is advised to make three more PNC contacts on day three, between days 7–14 after delivery, and six weeks after delivery [ 14 ]. The use of postnatal care has been limited in south Asia, especially in India. According to the 2020-21 National Family Health Survey [ 4 ], in urban areas, only 27.70 per cent mothers received postnatal care from within 2 days of delivery, while children who received a health check after birth are very low, i.e. 29.50 per cent. Despite this, many women who give birth in facilities are discharged within hours after childbirth, without any indication about where they can obtain further care or support. Utilization of postnatal care can be affected by large number of factors including socio-demographic factors, economic factors, accessibility and availability of maternal and child health services etc. Understanding the factors that influence care-seeking behavior for postpartum services in India is vital to improve quality of care and designing appropriate interventions. Our study tried to elucidate these factors with the objective to assess the utilization of post-natal services and factors influencing utilization of postnatal care services. Methodology A community based cross sectional study was carried out in Vijayanagar district of Kalyan Karnataka region from 2021-23. The study population comprised mothers who delivered in last 3 months and residing in rural and urban area of Vijayanagar district. Purposive sampling method was used to select the participants. The total sample of the study was 810 postpartum mothers. Purposive Sampling technique was employed by taking a list of mothers by anganwadis and primary health care centers. Anganwadi teachers from women and child welfare department and ASHA workers from health department were contacted and list of recently delivered women from these areas were selected for the study. Data was collected by conducting in-depth interview, using pretested structured questionnaire, after obtaining informed consent from mother. SES scale by Agrawala et al. 2005 [ 1 ], was used. Data analysed using Statistical Package for Social Sciences (SPSS version 26). Results and discussion Table 1 shows the demographic characteristics of mother. Majority of the mothers (56.00 %) were between 24-28 years, 24.80 per cent were between 19-23 years and 19.10 per cent of the mothers were between 29-32 years of age. Most of the mothers (58.40 %) married at the age of 18-21 years, 33.60 per cent between 22-25 years and 8.00 per cent were between 26-29 years. About 63.20 per cent of mothers had completed 1 to 2 years of their marriage, 30.10 per cent completed 3-4 years and 6.70 per cent competed 4 to 5 years. With respect to education about 31.70 per cent completed their secondary education, 16.20 per cent had PUC and Diploma education while 18.10 per cent and 5.30 per cent mothers completed graduation and post-graduation respectively. Majority of the mothers were homemakers (87.80) and only 12.20 percent were working . About 78.80 per cent belonged to rural locality whereas 21.20 per cent were from urban area. Majority of mothers (51.60) belong to nuclear family whereas 54.00 per cent were belonging to joint family. The size of the family 54 per cent of the mothers living in families having 1 - 5 family members, 38.10 per cent were living with 6 - 10 family members and 7.90 per cent of the mothers were living with more than 10 family members. Regarding socio-economic status of the family, 51.20 per cent of the participants belonged to lower middle SES followed by upper middle SES (36 %), high SES (9.10 %) , 2.20 per cent and 1.40 belong to poor and upper SES group respectively. Table 2 shows the distribution of maternal factors with respect to utilization of PNC services. With respect to antenatal visits majority of mothers 434 (53.60 %) received less than 4 antenatal visits and about 52.70 per cent of mothers received less than 4 postnatal visits/services. With respect to time of PNC visit, majority of mothers were aware about time of PNC visit. Majority of mothers (38.80 %) responded that mothers should receive PNC services within 24 hours of delivery followed by 2 to 3 days (33.70 %), 4 to 7 days (20.10 %) and 8 to 30 days (7.40 %). About duration of hospital stay, about 35.60 per cent of mothers stayed after delivery for 2 to 3 days, followed by 21 day (23.80 %), 3 to 5 days (20.50 %) and more than five days (20.10 %). Regarding knowledge about PNC services, majority of mothers (67.50) did not know about the PNC services and the most common postnatal services received was health checkup for infant (52.70 %), followed by immunization (47.30 %), family planning (25.70 %) and postnatal checkup for mother (27.00 %). With respect to postnatal services received by the mother, results revealed that, most common postnatal services received by the mother were mother card and madilu kit consisting of health information for the mother (75.80 %), followed by breast feeding counseling (73.70 %), iron and folic acid supplementation (59.60 %), psychological counseling (24.20 %) and nutritional counseling (10.30 %). Majority of mothers (77.90 %) received information about postnatal services by health workers followed by friends (22.10 %) and media (9.30 %). Majority of mothers (38.80 %) attended one time to postnatal services followed by 2 times (33.70 %) and 3 times (20.10 %). Reasons for not utilizing PNC services, about 50.00 per cent of mothers had no problem followed for not aware of the services are offered (34.90 %), cultural factors (10.10 %) and no PHC in the vicinity (4.90 %). With respect to decision about seeking health care services, majority of (49.90 %) mothers expressed that their health care decision was made by their partner, about 31.40 per cent mothers of noted that both make the decision about health care followed by self (13.80 %) and elders (4.90 %) about satisfaction with postnatal services offered, majority of mothers (59.30 %) satisfied with postnatal services offered followed by non-satisfaction (38.60 %). The overall prevalence of postpartum care services utilization was 32.46 (263 out of 810) (Fig.1). Mothers between 29 to 32 years had utilized postnatal care services than mothers between 19 to 23 years and 24 to 28 years (Table 3) the reason might be older mothers having health issues like gestational diabetes, thyroid problem and anaemia during pregnancy. This made them to take consultation of the delivery and older mothers had 1.98 times higher odds of utilizing PNC services than other group. The results of this study on par with study’s findings of [15] in M.P. [11,16] who showed that mothers between 25 to 34 years and above years had higher odds of utilizing postnatal care services and significant association between age of the mother and postnatal care services utilization. Educated mothers utilized more PNC services. Mothers who married at the age of 26 to 29 years had utilized PNC services than other group and odds of utilizing PNC services 1.21 times higher odds of risk compared to reference category and 22 to 25 years (Table 2 and 3). The mothers who do not utilized PNC services, the reason maybe is because they were more matured and aware of services and the women who married early were less empowered to take decisions. Regarding education and PNC service utilization mothers who had PUC and Diploma education had utilized PNC services and odds of utilizing PNC services was 1.33 times higher odds of risk compared to mothers who had primary and secondary education and who are graduates and illiterates. This may be due to educational level in mothers and lack of awareness about PNC services provided by government. These findings are in line with study done by [14] in Jabalpur district, India and [17] who showed that the educated mother's availed postnatal care services compared to illiterates. Education had significant association with postnatal care services utilization. Working mothers had utilized 1.71 times higher odds of risk of utilizing PNC services than homemakers. This may be due to working mothers had awareness about postnatal care, delivery complications and they had to return back to their work after availing six months of maternity leave and they may want to be healthy and fit similar results reported by [15, 11] who showed working mothers had 2.98 times and 1.48 times higher odds of risk of utilizing PNC services compare to home maker's. There is a significant association found between occupation and PNC service utilization. Mother who belonged to middle SES (32.80 %) had utilized PNC services followed by high SES (28.70 %) and poor SES (28.30 %). Bivariate analysis showed mothers who belonged to middle SES category were 1.77 times more likely to utilize PNC care services and mothers’ belonged poor SES group were 0.82 times lesser odds of risk of utilizing PNC care services than reference category. Mothers of low income group lack the financial assistance to visit the hospital or prioritise needs of the baby over their own health. The majorities of the participants in the study were daily wagers and are from poor family. Going for their own health will lead to wages loss of their husband, their husband do not get a frequent leaves are there may be time constraint. This maybe because women who used comprehensive prenatal care services received enough counseling regarding the postpartum care during their ANC visits. Mothers from rural area utilized PNC services compared to urban mothers and the odds of utilizing PNC services 1.53 times higher among rural mothers compared urban mothers. Significant association observed between locality and utilization of PNC services (Table 3). This could be in rural area ASHA workers from health department and Anganwadi workers child and women welfare department giving awareness on postnatal care they do visit PNC homes and they check for health of the mother and new born. These workers suggest and counsel the mothers about postnatal care and neonatal care. Anganwadi workers provide nutritional food to the mothers and twice in a month they visit for PNC services and weight of the mother and unit will be checked. In spite of government’s efforts to make home visits by healthcare provider (ASHA workers and Anganwadi workers) women in urban area are not utilizing the postnatal care services. Even more efficient strategies need to be planned to give education and awareness to the mothers, family and the community for better survival of mother and her infant. Contradictory results reported by [9, 2, 7] showed that mothers from urban area had utilized PNC services compared to rural mothers and significant association was also observed. This may be because in the present study rural women attended government hospitals and the strong network of ASHA workers and likely home visits increased the utilization of PNC services in rural area. Mothers who attended antenatal visits during their pregnancy more than four times utilized PNC services more compared to who did not. An odd of not utilizing PNC service was 1.50 times higher among those mothers who made few ANC visits. Similar results found by [7] who that mothers who did not attend ANC more than four times had 4.10 times higher odds of risk of utilizing PNC services compare to who did. Significant association was found between ANC attendance and utilization of services also studies conducted by [17, 12, 14, 5, 10, 6] showed significant association between ANC visits and postnatal care services utilization. The mothers who had more knowledge about postnatal care services utilized better PNC services and the risk of not utilizing was 1.39 times higher among mothers with poor knowledge compared to mothers who were aware knew about the PNC services. Conclusion Postnatal care services refers to physical examination, vaccination, health and nutrition education, successful breast feeding practices, care during puerperium and family planning services are the critical healthcare services which women require after giving birth. Utilization of postnatal health services is affected by various factors like accessibility, availability and quality as well as individual attitude and social economic status may influence the use of postnatal care services. The factors which influenced the utilization of postnatal care services were older mother, late marriage, working status of the mother, middle SES group, number of ANC visit and knowledge about PNC service. Declarations Acknowledgements I would like to thank my research guide for guiding me during my Ph.D work. We would like thank all the senior and junior teachers of department of Human Development and Family Studies, College of community Science, University of Agricultural Sciences, Dharwad, Karnataka, India. Author contributions The design and conception of the study were led by SNH. She was responsible for developing the interview topic guide, which was further refined by VM. The manuscript write-up, data analysis, proofreading, and formatting were conducted by SNH. All authors actively participated in reading and approving the final manuscript. Funding This research was fully self-funded. Data availability The datasets utilized and analyzed in the present study are available from the corresponding author upon reasonable request. Ethics approval and consent to participate Informed written consent was obtained from all participants. This study was approved by the ethics committee of University of Agricultural Sciences, Dharwad, Karnataka, India. Additionally permission was obtained from the primary health care centers at local level. Consent for publication Not Applicable. Competing interests The authors declare no competing interests. Author details 1 Assistant Professor, Dept. of Home Science, UAS, Raichur. 2 Assistant Professor, Dept.of human development and family studies, UAS, Dharwad. References Aggarwal O P, Bhasin S K, Sharma A K, Chhabra P, Aggarwal K and Rajoura O P, 2005, A new instrument scale for measuring the socio-economic status of a family: preliminary study . Indian Journal of Community Medicine, 34(4): 111-114. Angore N B, Tufa G E and Bisetegen S F, 2018, Determinants of postnatal care utilization in urban community among women in Debre Birhan Town, Northern Shewa, Ethiopia. Journal of Health, Population and Nutrition , 37(10):1-9. Anonymous, 2020, A handbook for building skills, Counseling for maternal and newborn health care. WHO, 1-244. https://www.who.int/publications/i/item/9789241547628 Anonymous, 2020, National Family Health Survey (NFHS): Observations, significance and way ahead. Database that strengthen India's demographic and health policies and programmes. www.google.com. Bose S, Lavanya K M, Chintada and Vutharkar, 2020, Evaluation of utilization of postnatal care services among women of Urban Slums in Rajahmundry, Andhra Pradesh, India. Journal of Data Meghe Institute of Medical Sciences Universi t y , 15: 643-648. Chhetri S, Shah R and Rajbanshi L, 2020, Factors associated with utilization of complete postnatal care service in Baglung municipality, Nepal. International Journal of Reproductive Medicine.20: 1-8. Dona A, Tulicha T, Arcicha A and Dabaro D, 2022, Factors influencing utilization of early postnatal care services among postpartum women in Yirgalen town, Sidama regional state, Ethiopia. Sage open medicine, doi:10.1177/20503121221088098. Fraser D M, Cooper M A, Nolte A G W, 2010, Myles textbook for midwives African edition. 2 nd edition. London: Elsevier . Karanati K, Ashok K R and Pravallika S, 2020, A cross sectional study on utilization of postnatal services in rural health training centre, Chandragiri, Andhra Pradesh . Indian journal of forensic and community medicine , 7 (1):24-28. Kardalkar S, Sherkhane MS. Utilization of Postnatal Care Services among Women of Urban Slums. National Journal of Community Medicine , 9(9):684-688. Khaki J J and Sithole L, 2019, Factors associated with the utilization of postnatal care services among Malawian women. M alawi medical journal , 31 (1): 2-11. Mon A S, Phyu M K, Thinkhamrop W and Thinkhamrop B. Utilization of full postnatal care services among rural Myanmar women and its determinants: a cross-sectional study. F1000research, 7:1167-1171. Muktamath V U, Sadhana Kulloli and Hegde P R, 2022, Postnatal Care of Mothers: Knowledge, Nutritional Status and Utilization of Postnatal Care Services. Journal education psychiatric research , 4(1): 312-319. Pandey D, Meshram P, Sharma A, Tiwari R and Kasar P K, 2019, An assessment of utilization of postnatal care services in urban area Jabalpur district. International Journal of Community Medicine and Public Health , 6(9): 3660-3666. Sharma A, Thakur S P, Kasar K P, Tiwari R and Sharma R, 2014, Utilization of postnatal care in tribal area of Madhya Pradesh: A community based cross sectional study. International Journal of Medical Science and Public Health, 3(10): 1266-1271. Tessema T Z, Yazachew L, Tesema A G and Teshale B A, 2020, Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub Saharan countries . Italian Journal of Pediatrics, 46 (175): 2-11. 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Tables Table 1: Distribution of postpartum mothers based on demographic profile Characteristics Category Frequency Percentage Age of the mother (years) 19-23 201 24.80 24-28 454 56.00 29-32 155 19.10 Age at marriage (years) 18-21 473 58.40 22-25 272 33.60 26-29 65 8.00 Education of the mother Illiterate 148 18.30 Primary 84 10.40 Secondary 257 31.70 PUC and Diploma 131 16.20 Graduation 147 18.10 Post graduation 43 5.30 Occupation of the mother Homemaker 711 87.80 Working 99 12.20 Locality Rural 638 78.80 Urban 172 21.20 Type of family Nuclear 480 51.60 Joint 392 48.40 Size of the family 1-5 437 54.00 6-10 309 38.10 More than 10 64 7.90 Socio economic status of the family Upper high 11 1.40 High 74 9.10 Upper middle 292 36.00 Lower middle 415 51.20 Poor 18 2.20 Table 2: Utilization of postnatal care services by postpartum mothers based on maternal factors N=810 Factors Category Frequency Percentage Antenatal visits < 4 visits 434 53.60 ≥ 4 visits 376 46.40 Postnatal visits < 4 visits 614 75.80 ≥ 4 visits 196 24.19 Postnatal service did you receive Check up 427 52.70 Immunization 383 47.30 Family planning 208 25.70 Postnatal check-up for both baby and mother 219 27.00 Type of postnatal service received Getting MADILU kit 614 75.80 Iron and folic acid supplementation 483 59.60 Psychological counseling 196 24.19 Clothing for baby & mother - - Nutritional counseling 56 10.30 Breast feeding counseling 597 73.70 Source of information about postnatal services Friends 179 22.10 Media 75 9.30 Health workers 631 77.90 Postnatal care services attendance after delivery 1 time 314 38.80 2 time 273 33.70 3 time 163 20.10 More than 3 time 60 7.40 Reasons for not utilizing PNC service Not aware the services are offered 283 34.90 Had no problem 405 50.00 No PHC in the vicinity 40 4.90 Cultural factors 82 10.10 Decision about seeking health care services Self 112 13.80 Partner 404 49.90 Both 254 31.40 Elders 40 4.90 Satisfaction with PNC services No 313 38.60 Yes 480 59.30 Table 3: Bivariate analysis of factors associated with utilization of postnatal care services N=810 Characteristics Category Not -utilized n=547 Utilized n=263 OR P value N (%) N (%) Age of mother (years) 19-23 years 132 (65.70) 69 (34.30) 1 0.000 ** 24-28 years 339 (74.70) 115 (25.30) 0.649 (0.453, 0.930) 29-32 years 76 (49.00) 79 (51.00) 1.989 (1.295, 3.054) Age at marriage (years) 18-21 years 305 (64.50) 168 (35.50) 1 0.007 ** 22-25 years 203 (74.60) 69 (25.40) 0.617 (0.443, 0.860) 26-29 years 39 (60.00) 26 (40.00) 1.210 (0.712, 2.058) Education of mother Illiterate 96 (69.10) 43 (30.90) 1 0.152 NS Primary and secondary 58 (74.40) 20 (25.60) 0.770 (0.413, 1.435) PUC and Diploma 167 (62.50) 100 (37.50) 1.337 (0.864, 2.069) Graduation and above 226 (69.30) 100 (13.70) 0.988 (0.643, 1.518) Occupation of mother Homemaker 491 (69.10) 220 (30.90) 1 0.014 * Working 56 (56.60) 43 (43.40) 1.714 (1.117, 2.629) Locality Rural 103 (59.90) 69 (40.10) 1.53 (1.08, 2.17) 0.016 * Urban 444 (69.60) 194 (30.40) 1 Socio economic status of the family High 133 (67.20) 65 (32.80) 1 0.001 ** Middle 68 (53.50) 59 (46.50) 1.775 (1.123, 2.806) Poor 346 (71.30) 139 (28.70) 0.822 (0.576, 1.173) ANC Visit ≥4 Visits 236 (62.80) 140 (37.20) 1.500 (1.116, 2.016) 0.007 ** < Visits 311 (71.70) 123 (28.30) 1 PNC services knowledge Yes 244 (63.70) 139 (36.30) 1.392 (1.036, 1.870) 0.028 * No 303 (71.00) 124 (29.00) 1 Figures in the parentheses indicates percentage * Significant at 5 per cent level ** Significant at 1 per cent level Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 24 Sep, 2024 Reviews received at journal 15 Sep, 2024 Reviewers agreed at journal 08 Sep, 2024 Reviewers agreed at journal 05 Sep, 2024 Reviewers agreed at journal 05 Sep, 2024 Reviewers agreed at journal 03 Sep, 2024 Reviews received at journal 13 Aug, 2024 Reviewers agreed at journal 01 Aug, 2024 Reviews received at journal 15 Jul, 2024 Reviewers agreed at journal 14 Jul, 2024 Reviewers agreed at journal 11 Jul, 2024 Reviewers agreed at journal 26 Jun, 2024 Reviewers invited by journal 25 Jun, 2024 Editor invited by journal 12 Apr, 2024 Editor assigned by journal 12 Apr, 2024 Submission checks completed at journal 12 Apr, 2024 First submitted to journal 06 Apr, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4226105","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":291531212,"identity":"89edaa1c-b526-4912-802f-124448c6d3ab","order_by":0,"name":"Sunitha N H","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABD0lEQVRIie3OMUsDMRTA8VcO7BK9NVLFrxAJVOSgfpWEg3Y5uxREqdCbzkVwPeiXCHRxcHhHwFvifkVnpw7XrV2KZziEwt3QzSF/EkJCfvAAXK5/GnZiANaN7YUAtadnVyvJfgnBAwhYQkV9+yMtXaS3mV6/DsZXp6vL9fZtcObPn/sl3Acy7h5jE2HFWGBmwsn1POI98h0S+mV4CmYkY+9ENBIaMcwST6rPiPUAPVK9cOgkuiKENQ9myUyqpeHbDc5qsmsnUFiipSpInxLUNYnbCTMrhh9JLpUZ3gUEc0KL4QTE+4gnbYM9Rbx8SKZS5Xqx3OD0xk/DBZSPwfmLb5oHa05U++iA/y6Xy+Xa7wfzi2Lv5r77ywAAAABJRU5ErkJggg==","orcid":"","institution":"University of Agricultural Sciences, Dharwad","correspondingAuthor":true,"prefix":"","firstName":"Sunitha","middleName":"N","lastName":"H","suffix":""},{"id":291531213,"identity":"479d72db-edbe-4ee8-9802-ba9e26a8ba52","order_by":1,"name":"Vinutha Muktamath","email":"","orcid":"","institution":"University of Agricultural Sciences, Dharwad","correspondingAuthor":false,"prefix":"","firstName":"Vinutha","middleName":"","lastName":"Muktamath","suffix":""}],"badges":[],"createdAt":"2024-04-06 06:59:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4226105/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4226105/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55003725,"identity":"71cb0e97-bcf8-4b9d-9ad6-d5780ca793cc","added_by":"auto","created_at":"2024-04-19 18:43:33","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":13995,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eOverall utilization of PNC services by mothers\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4226105/v1/d08dea7fa5cb171ff18e050d.png"},{"id":55005723,"identity":"74f71fe4-3c86-4fac-ae6f-d760849c1ed7","added_by":"auto","created_at":"2024-04-19 18:51:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":464639,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4226105/v1/590dfc18-9625-4256-81c8-d6fa2d7c559a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors influencing utilization of postnatal care services among postpartum mothers of Vijayanagara district,Karnataka, India","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn a respectful atmosphere, pregnancy, childbirth, and parenting can effectively uphold women's rights and social standing without compromising their health. Safe motherhood and childbirth are made possible by the support that communities and families give expectant mothers and their newborns, the expertise of medical professionals, and the availability of sufficient medical facilities, supplies and emergency care when needed [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOver 500,000 women worldwide lose their lives during or shortly after giving birth to children each year; over 90 per cent of these deaths take place in underdeveloped nations [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The postnatal phase lasts six weeks from the time a baby is delivered until the reproductive organs revert to their typical non-pregnant state [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. For the well being of both the mother and the child, the timing of postnatal care is equally essential.\u003c/p\u003e \u003cp\u003eStudies have indicated that the \"immediate postnatal period,\" which lasts for 24 hours following delivery, accounts for 50% of maternal mortality and 40% of neonatal deaths. The World Health Organization advises women who give birth in a medical facility to get PNC for at least 24 hours following the birth. The first postnatal visit should happen as soon as after delivery\u0026mdash;ideally within 24 hours\u0026mdash;if the birth takes place at home. It is advised to make three more PNC contacts on day three, between days 7\u0026ndash;14 after delivery, and six weeks after delivery [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe use of postnatal care has been limited in south Asia, especially in India. According to the 2020-21 National Family Health Survey [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], in urban areas, only 27.70 per cent mothers received postnatal care from within 2 days of delivery, while children who received a health check after birth are very low, i.e. 29.50 per cent. Despite this, many women who give birth in facilities are discharged within hours after childbirth, without any indication about where they can obtain further care or support.\u003c/p\u003e \u003cp\u003eUtilization of postnatal care can be affected by large number of factors including socio-demographic factors, economic factors, accessibility and availability of maternal and child health services etc. Understanding the factors that influence care-seeking behavior for postpartum services in India is vital to improve quality of care and designing appropriate interventions. Our study tried to elucidate these factors with the objective to assess the utilization of post-natal services and factors influencing utilization of postnatal care services.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eA community based cross sectional study was carried out in Vijayanagar district of Kalyan Karnataka region from 2021-23. The study population comprised mothers who delivered in last 3 months and residing in rural and urban area of Vijayanagar district. Purposive sampling method was used to select the participants. The total sample of the study was 810 postpartum mothers.\u003c/p\u003e \u003cp\u003ePurposive Sampling technique was employed by taking a list of mothers by anganwadis and primary health care centers. Anganwadi teachers from women and child welfare department and ASHA workers from health department were contacted and list of recently delivered women from these areas were selected for the study.\u003c/p\u003e \u003cp\u003eData was collected by conducting in-depth interview, using pretested structured questionnaire, after obtaining informed consent from mother. SES scale by Agrawala \u003cem\u003eet al.\u003c/em\u003e 2005 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], was used. Data analysed using Statistical Package for Social Sciences (SPSS version 26).\u003c/p\u003e"},{"header":"Results and discussion","content":"\u003cp\u003eTable 1 shows the demographic characteristics of mother. Majority of the mothers \u0026nbsp; (56.00 %) were between 24-28 years, 24.80 per cent were between 19-23 years and 19.10 per cent of the mothers were between 29-32 years of age. Most of the mothers (58.40 %) married at the age of 18-21 years, 33.60 per cent between 22-25 years and 8.00 per cent were between 26-29 years. About 63.20 per cent of mothers had completed 1 to 2 years of their marriage, 30.10 per cent completed 3-4 years and 6.70 per cent competed 4 to 5 years.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWith respect to education about 31.70 per cent completed their secondary education, 16.20 per cent had PUC and Diploma education while 18.10 per cent and 5.30 per cent mothers completed graduation and post-graduation respectively. Majority of the mothers were homemakers (87.80) and only 12.20 percent were working\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eAbout 78.80 per cent belonged to rural locality whereas 21.20 per cent were from urban area. Majority of mothers (51.60) belong to nuclear family whereas 54.00 per cent were belonging to joint family. The size of the family 54 per cent of the mothers living in families having 1 - 5 family members, 38.10 per cent were living with 6 - 10 family members and 7.90 per cent of the mothers were living with more than 10 family members.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Regarding socio-economic status of the family, 51.20 per cent of the participants belonged to lower middle SES followed by upper middle SES (36 %), high SES (9.10 %) , 2.20 per cent and 1.40 belong to poor and upper SES group respectively.\u003c/p\u003e\n\u003cp\u003eTable 2 shows the distribution of maternal factors with respect to utilization of PNC services. With respect to antenatal visits majority of mothers 434 (53.60 %) received less than 4 antenatal visits and about 52.70 per cent of mothers received less than 4 postnatal visits/services. With respect to time of PNC visit, majority of mothers were aware about time of PNC visit. Majority of mothers (38.80 %) responded that mothers should receive PNC services within 24 hours of delivery followed by 2 to 3 days (33.70 %), 4 to 7 days (20.10 %) and 8 to 30 days (7.40 %). About duration of hospital stay, about 35.60 per cent of mothers stayed after delivery for 2 to 3 days, followed by 21 day (23.80 %), 3 to 5 days (20.50 %) and more than five days (20.10 %). Regarding knowledge about PNC services, majority of mothers (67.50) did not know about the PNC services and the most common postnatal services received was health checkup for infant (52.70 %), followed by immunization (47.30 %), family planning (25.70 %) and postnatal checkup for mother (27.00 %).\u003c/p\u003e\n\u003cp\u003eWith respect to postnatal services received by the mother, results revealed that, most common postnatal services received by the mother were mother card and madilu kit consisting of health information for the mother (75.80 %), followed by breast feeding counseling (73.70 %), iron and folic acid supplementation (59.60 %), psychological counseling (24.20 %) and nutritional counseling (10.30 %). Majority of mothers (77.90 %) received information about postnatal services by health workers followed by friends (22.10 %) and media (9.30 %).\u003c/p\u003e\n\u003cp\u003eMajority of mothers (38.80 %) attended one time to postnatal services followed by 2 times (33.70 %) and 3 times (20.10 %). Reasons for not utilizing PNC services, about 50.00 per cent of mothers had no problem followed for not aware of the services are offered (34.90 %), cultural factors (10.10 %) and no PHC in the vicinity (4.90 %). With respect to decision about seeking health care services, majority of (49.90 %) mothers expressed that their health care decision was made by their partner, about 31.40 per cent mothers of noted that both make the decision about health care followed by self (13.80 %) and elders (4.90 %) about satisfaction with postnatal services offered, majority of mothers (59.30 %) satisfied with postnatal services offered followed by non-satisfaction (38.60 %).\u003c/p\u003e\n\u003cp\u003eThe overall prevalence of postpartum care services utilization was 32.46 (263 out of 810) (Fig.1). Mothers between 29 to 32 years had utilized postnatal care services than mothers between 19 to 23 years and 24 to 28 years (Table 3) the reason might be older mothers having health issues like gestational diabetes, thyroid problem and anaemia during pregnancy. This made them to take consultation of the delivery and older mothers had 1.98 times higher odds of utilizing PNC services than other group. The results of this study on par with study’s findings of [15] in M.P. [11,16] who showed that mothers between 25 to 34 years and above years had higher odds of utilizing postnatal care services and significant association between age of the mother and postnatal care services utilization. Educated mothers utilized more PNC services.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMothers who married at the age of 26 to 29 years had utilized PNC services than other group and odds of utilizing PNC services 1.21 times higher odds of risk compared to reference category and 22 to 25 years (Table 2 and 3). The mothers who do not utilized PNC services, the reason maybe \u003cstrong\u003eis\u0026nbsp;\u003c/strong\u003ebecause they were more matured and aware of services and the women who married early were less empowered to take decisions. Regarding education and PNC service utilization mothers who had PUC and Diploma education had utilized PNC services and odds of utilizing PNC services was 1.33 times higher odds of risk compared to mothers who had primary and secondary education and who are graduates and illiterates. This may be due to educational level in mothers and lack of awareness about PNC services provided by government. These findings are in line with study done by [14] in Jabalpur district, India and [17] who showed that the educated mother's availed postnatal care services compared to illiterates. Education had significant association with postnatal care services utilization.\u003c/p\u003e\n\u003cp\u003eWorking mothers had utilized 1.71 times higher odds of risk of utilizing PNC services than homemakers. This may be due to working mothers had awareness about postnatal care, delivery complications and they had to return back to their work after availing six months of maternity leave and they may want to be healthy and fit similar results reported by [15, 11] who showed working mothers had 2.98 times and 1.48 times higher odds of risk of utilizing PNC services compare to home maker's. There is a significant association found between occupation and PNC service utilization.\u003c/p\u003e\n\u003cp\u003eMother who belonged to middle SES (32.80 %) had utilized PNC services followed by high SES (28.70 %) and poor SES (28.30 %). Bivariate analysis showed mothers who belonged to middle SES category were 1.77 times more likely to utilize PNC care services and mothers’ belonged poor SES group were 0.82 times lesser odds of risk of utilizing PNC care services than reference category. Mothers of low income group lack the financial assistance to visit the hospital or prioritise needs of the baby over their own health. The majorities of the participants in the study were daily wagers and are from poor family. Going for their own health will lead to wages loss of their husband, their husband do not get a frequent leaves are there may be time constraint. This maybe because women who used comprehensive prenatal care services received enough counseling regarding the postpartum care during their ANC visits.\u003c/p\u003e\n\u003cp\u003eMothers from rural area utilized PNC services compared to urban mothers and the odds of utilizing PNC services 1.53 times higher among rural mothers compared urban mothers. Significant association observed between locality and utilization of PNC services (Table 3). This could be in rural area ASHA workers from health department and Anganwadi workers child and women welfare department giving awareness on postnatal care they do visit PNC homes and they check for health of the mother and new born. These workers suggest and counsel the mothers about postnatal care and neonatal care. Anganwadi workers provide nutritional food to the mothers and twice in a month they visit for PNC services and weight of the mother and unit will be checked.\u003c/p\u003e\n\u003cp\u003eIn spite of government’s efforts to make home visits by healthcare provider (ASHA workers and Anganwadi workers) women in urban area are not utilizing the postnatal care services. Even more efficient strategies need to be planned to give education and awareness to the mothers, family and the community for better survival of mother and her infant. Contradictory results reported by [9, 2, 7] showed that mothers from urban area had utilized PNC services compared to rural mothers and significant association was also observed. This may be because in the present study rural women attended government hospitals and the strong network of ASHA workers and likely home visits increased the utilization of PNC services in rural area. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMothers who attended antenatal visits during their pregnancy more than four times utilized PNC services more compared to who did not. An odd of not utilizing PNC service was 1.50 times higher among those mothers who made few ANC visits. Similar results found by [7] who that mothers who did not attend ANC more than four times had 4.10 times higher odds of risk of utilizing PNC services compare to who did.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSignificant association was found between ANC attendance and utilization of services also studies conducted by [17, 12, 14, 5, 10, 6] showed significant association between ANC visits and postnatal care services utilization. The mothers who had more knowledge about postnatal care services utilized better PNC services and the risk of not utilizing was 1.39 times higher among mothers with poor knowledge compared to mothers who were aware knew about the PNC services.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePostnatal care services refers to physical examination, vaccination, health and nutrition education, successful breast feeding practices, care during puerperium and family planning services are the critical healthcare services which women require after giving birth. Utilization of postnatal health services is affected by various factors like accessibility, availability and quality as well as individual attitude and social economic status may influence the use of postnatal care services. The factors which influenced the utilization of postnatal care services were older mother, late marriage, working status of the mother, middle SES group, number of ANC visit and knowledge about PNC service.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI would like to thank my research guide for guiding me during my Ph.D work. \u0026nbsp;We would like thank all the senior and junior teachers of department of Human Development and Family Studies, College of community Science, University of Agricultural Sciences, Dharwad, Karnataka, India.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe design and conception of the study were led by SNH. She was responsible for developing the interview topic guide, which was further refined by VM. The manuscript write-up, data analysis, proofreading, and formatting were conducted by SNH. All authors actively participated in reading and approving the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was fully self-funded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets utilized and analyzed in the present study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed written consent was obtained from all participants. This study was approved by the ethics committee of University of Agricultural Sciences, Dharwad, Karnataka, India. Additionally permission was obtained from the primary health care centers at local level.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1 Assistant Professor, Dept. of Home Science, UAS, Raichur.\u003c/p\u003e\n\u003cp\u003e2 Assistant Professor, Dept.of human development and family studies, UAS, Dharwad.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAggarwal O P, Bhasin S K, Sharma A K, Chhabra P, Aggarwal K and Rajoura O P, 2005, A new instrument scale for measuring the socio-economic status of a family: preliminary study\u003cem\u003e. Indian Journal of Community Medicine,\u003c/em\u003e 34(4): 111-114.\u003c/li\u003e\n\u003cli\u003eAngore N B, Tufa G E and Bisetegen S F, 2018, Determinants of postnatal care utilization in urban community among women in Debre Birhan Town, Northern Shewa, Ethiopia. \u003cem\u003eJournal of Health, Population and Nutrition\u003c/em\u003e, 37(10):1-9. \u003c/li\u003e\n\u003cli\u003eAnonymous, 2020, A handbook for building skills, Counseling for maternal and newborn health care. WHO, 1-244. https://www.who.int/publications/i/item/9789241547628 \u003c/li\u003e\n\u003cli\u003eAnonymous, 2020, National Family Health Survey (NFHS): Observations, significance and way ahead. Database that strengthen India\u0026apos;s demographic and health policies and programmes. www.google.com. \u003c/li\u003e\n\u003cli\u003eBose S, Lavanya K M, Chintada and Vutharkar, 2020, Evaluation of utilization of postnatal care services among women of Urban Slums in Rajahmundry, Andhra Pradesh, India. \u003cem\u003eJournal of Data Meghe Institute of Medical Sciences Universi\u003c/em\u003et\u003cem\u003ey\u003c/em\u003e, 15: 643-648. \u003c/li\u003e\n\u003cli\u003eChhetri S, Shah R and Rajbanshi L, 2020, Factors associated with utilization of complete postnatal care service in Baglung municipality, Nepal. \u003cem\u003eInternational Journal of Reproductive Medicine.20: 1-8.\u003c/em\u003e\u003c/li\u003e\n\u003cli\u003eDona A, Tulicha T, Arcicha A and Dabaro D, 2022, Factors influencing utilization of early postnatal care services among postpartum women in Yirgalen town, Sidama regional state, Ethiopia. \u003cem\u003eSage open medicine,\u003c/em\u003e doi:10.1177/20503121221088098.\u003c/li\u003e\n\u003cli\u003eFraser D M, Cooper M A, Nolte A G W, 2010, Myles textbook for midwives African edition. 2\u003csup\u003end\u003c/sup\u003e edition. London: \u003cem\u003eElsevier\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eKaranati K, Ashok K R and Pravallika S, 2020, A cross sectional study on utilization of postnatal services in rural health training centre, Chandragiri, Andhra Pradesh\u003cem\u003e. Indian journal of forensic and community medicine\u003c/em\u003e, 7 (1):24-28.\u003c/li\u003e\n\u003cli\u003eKardalkar S, Sherkhane MS. Utilization of Postnatal Care Services among Women of Urban Slums. \u003cem\u003eNational Journal of Community Medicine\u003c/em\u003e, 9(9):684-688. \u003c/li\u003e\n\u003cli\u003eKhaki J J and Sithole L, 2019, Factors associated with the utilization of postnatal care services among Malawian women. \u003cem\u003eM\u003c/em\u003e\u003cem\u003ealawi medical journal\u003c/em\u003e, 31 (1): 2-11.\u003c/li\u003e\n\u003cli\u003eMon A S, Phyu M K, Thinkhamrop W and Thinkhamrop B. Utilization of full postnatal care services among rural Myanmar women and its determinants: a cross-sectional study. \u003cem\u003eF1000research,\u003c/em\u003e 7:1167-1171.\u003c/li\u003e\n\u003cli\u003eMuktamath V U, Sadhana Kulloli and Hegde P R, 2022, Postnatal Care of Mothers: Knowledge, Nutritional Status and Utilization of Postnatal Care Services. \u003cem\u003eJournal education psychiatric research\u003c/em\u003e, 4(1): 312-319.\u003c/li\u003e\n\u003cli\u003ePandey D, Meshram P, Sharma A, Tiwari R and Kasar P K, 2019, An assessment of utilization of postnatal care services in urban area Jabalpur district. \u003cem\u003eInternational Journal of Community Medicine and Public Health\u003c/em\u003e, 6(9): 3660-3666.\u003c/li\u003e\n\u003cli\u003eSharma A, Thakur S P, Kasar K P, Tiwari R and Sharma R, 2014, Utilization of postnatal care in tribal area of Madhya Pradesh: A community based cross sectional study. \u003cem\u003eInternational Journal of Medical Science and Public Health,\u003c/em\u003e 3(10): 1266-1271.\u003c/li\u003e\n\u003cli\u003eTessema T Z, Yazachew L, Tesema A G and Teshale B A, 2020, Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub Saharan countries\u003cem\u003e. Italian Journal of Pediatrics, \u003c/em\u003e46 (175): 2-11.\u003c/li\u003e\n\u003cli\u003eUpadhyai N and Gupt S K, 2019, Utilization of postnatal care services and factors affecting it among women of urban slums in Dehradun, Uttarkhand. \u003cem\u003eIndian Journal community Health\u003c/em\u003e, 31(4): 470-476.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Distribution of postpartum mothers based on demographic profile\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.84%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.48%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.24%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.44%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.84%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of the mother (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.48%\"\u003e\n \u003cp\u003e19-23\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.24%\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.44%\"\u003e\n \u003cp\u003e24.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003e24-28\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e454\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e56.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003e29-32\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e19.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.84%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at marriage\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.48%\"\u003e\n \u003cp\u003e18-21\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.24%\"\u003e\n \u003cp\u003e473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.44%\"\u003e\n \u003cp\u003e58.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003e22-25\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e272\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e33.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003e26-29\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e8.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.84%\" rowspan=\"6\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation of the mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.48%\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.24%\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.44%\"\u003e\n \u003cp\u003e18.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e10.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e31.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003ePUC and Diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e16.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eGraduation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e18.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003ePost graduation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e5.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.84%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of the mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.48%\"\u003e\n \u003cp\u003eHomemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.24%\"\u003e\n \u003cp\u003e711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.44%\"\u003e\n \u003cp\u003e87.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eWorking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e12.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocality\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eRural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e638\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e78.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eUrban\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e21.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e51.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eJoint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e392\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e48.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eSize of the family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e54.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e38.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eMore than 10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e7.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocio economic status of the family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUpper high\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e9.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eUpper middle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e36.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003eLower middle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e51.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.691489361702125%\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.319148936170212%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.98936170212766%\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Utilization of postnatal care services by postpartum mothers based on maternal factors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; N=810\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntenatal visits\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003e\u0026lt; 4 visits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e434\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e53.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003e\u0026ge; 4 visits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e46.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostnatal visits\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003e\u0026lt; 4 visits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e75.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003e\u0026ge; 4 visits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e24.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostnatal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eservice did you receive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003eCheck up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e427\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e52.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eImmunization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e383\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e47.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eFamily planning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e25.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003ePostnatal check-up for both baby and mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e27.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"6\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of postnatal service received\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003eGetting MADILU kit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e75.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eIron and folic acid supplementation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e483\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e59.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003ePsychological counseling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e24.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eClothing for baby \u0026amp; mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eNutritional counseling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e10.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eBreast feeding counseling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e597\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e73.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of information about postnatal services\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003eFriends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e22.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eMedia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e9.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eHealth workers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e77.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostnatal care services attendance after delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003e1 time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e38.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003e2 time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e33.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003e3 time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e20.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eMore than 3 time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e7.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eReasons for not utilizing PNC service\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003eNot aware the services are offered\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e283\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e34.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eHad no problem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e405\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eNo PHC in the vicinity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e4.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eCultural factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e10.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecision about seeking health care services\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003eSelf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e13.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003ePartner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e49.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eBoth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e31.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eElders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e4.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.84%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eSatisfaction with PNC services\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.16%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.24%\"\u003e\n \u003cp\u003e313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.76%\"\u003e\n \u003cp\u003e38.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.110864745011085%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.733924611973393%\"\u003e\n \u003cp\u003e480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.155210643015522%\"\u003e\n \u003cp\u003e59.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Bivariate analysis of factors associated with utilization of postnatal care services\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; N=810\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot -utilized\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=547\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e\u003cstrong\u003eUtilized\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=263\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.87958115183246%\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.12041884816754%\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of mother (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003e19-23 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e132 (65.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e69 (34.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.000\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003e24-28 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e339 (74.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e115 (25.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e0.649\u003c/p\u003e\n \u003cp\u003e(0.453, 0.930)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003e29-32 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e76 (49.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e79 (51.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1.989\u003c/p\u003e\n \u003cp\u003e(1.295, 3.054)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at marriage\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003e18-21 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e305 (64.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e168 (35.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.007\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003e22-25 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e203 (74.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e69 (25.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e0.617\u003c/p\u003e\n \u003cp\u003e(0.443, 0.860)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003e26-29 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e39 (60.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e26 (40.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1.210\u003c/p\u003e\n \u003cp\u003e(0.712, 2.058)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation of mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e96 (69.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e43 (30.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"4\"\u003e\n \u003cp\u003e0.152\u003csup\u003eNS\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003ePrimary and secondary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e58 (74.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e20 (25.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e0.770\u003c/p\u003e\n \u003cp\u003e(0.413, 1.435)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003ePUC and Diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e167 (62.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e100 (37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1.337\u003c/p\u003e\n \u003cp\u003e(0.864, 2.069)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003eGraduation and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e226 (69.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e100 (13.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e0.988\u003c/p\u003e\n \u003cp\u003e(0.643, 1.518)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003eHomemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e491 (69.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e220 (30.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.014\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003eWorking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e56 (56.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e43 (43.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1.714\u003c/p\u003e\n \u003cp\u003e(1.117, 2.629)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocality\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003eRural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e103 (59.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e69 (40.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003cp\u003e(1.08, 2.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.016\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003eUrban\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e444 (69.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e194 (30.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocio economic status of the family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e133 (67.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e65 (32.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.001\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003eMiddle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e68 (53.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e59 (46.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1.775\u003c/p\u003e\n \u003cp\u003e(1.123, 2.806)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e346 (71.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e139 (28.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e0.822\u003c/p\u003e\n \u003cp\u003e(0.576, 1.173)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eANC Visit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003e\u0026ge;4 Visits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e236 (62.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e140 (37.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1.500\u003c/p\u003e\n \u003cp\u003e(1.116, 2.016)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.007\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003e\u0026lt; Visits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e311 (71.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e123 (28.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31645569620253%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ePNC services knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.139240506329113%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.981012658227849%\"\u003e\n \u003cp\u003e244 (63.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.240506329113924%\"\u003e\n \u003cp\u003e139 (36.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.40506329113924%\"\u003e\n \u003cp\u003e1.392\u003c/p\u003e\n \u003cp\u003e(1.036, 1.870)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.917721518987342%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.028\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.31017369727047%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.062034739454095%\"\u003e\n \u003cp\u003e303 (71.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.332506203473944%\"\u003e\n \u003cp\u003e124 (29.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.29528535980149%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFigures in the parentheses indicates percentage\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003eSignificant at 5 per cent level\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e**\u0026nbsp;\u003c/sup\u003eSignificant at 1 per cent level\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Postnatal care services, Utilization, Socio-economic status, antenatal visits and prevalence.","lastPublishedDoi":"10.21203/rs.3.rs-4226105/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4226105/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIndia has made tremendous progress in reducing MMR by 92 per cent since 2020, but still efforts are required to achieve the new SDG target. Vijayanagara district of Karnataka is a district of Kalyan Karnataka with poor maternal and infant health practices according to National family health survey V report. Hence the present study was conducted with the objective to assess the utilization of post-natal services (PNC) and study the factors influencing utilization of postnatal care services. A community based cross sectional study was conducted in the year 2021-23 in Vijayanagar district on a sample of 810 mothers within 3 months of delivery. Pre-tested questionnaire was used to elicit the information on utilization of postnatal care services and demographic information. SES scale by Agarwala \u003cem\u003eet al\u003c/em\u003e. 2005 was used. Data was analyzed using SPSS package Version 26. Results revealed that the overall prevalence of utilization of postnatal care services was 32.46 per cent out of 810 mothers. Mothers between 29 to 32 years had utilized postnatal care services, mothers from middle SES (46.50 %) group, who had ANC attendance, who had knowledge on PNC services (36.30 %) were utilized all the recommended PNC services. Socioeconomic status, age of mother, number of ANC visits and knowledge on postnatal care services were found to be significant factors affecting postnatal care services utilization. The study revealed low level of utilization of postnatal care services among mother (32.46 %). \u0026nbsp;This emphasizes the need to educate pregnant and lactating mothers regarding the importance of PNC services.\u003c/p\u003e","manuscriptTitle":"Factors influencing utilization of postnatal care services among postpartum mothers of Vijayanagara district,Karnataka, India","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-19 18:43:28","doi":"10.21203/rs.3.rs-4226105/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-09-25T03:44:50+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-15T07:03:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310517342462436587598910970942660359054","date":"2024-09-09T01:57:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"54715361850806722660571187595008900483","date":"2024-09-05T07:20:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"230659929658180124608666566293010706415","date":"2024-09-05T05:34:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"273840606119926234688092289051503791168","date":"2024-09-03T06:42:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-13T07:09:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"5755685618607844450213601481503119087","date":"2024-08-02T03:53:01+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-15T18:08:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"69840790200343809319965072953448405187","date":"2024-07-14T18:28:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50672864415928380498838775158158907825","date":"2024-07-12T00:29:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"40182472190570326062635496177177699266","date":"2024-06-26T04:33:25+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-06-25T16:01:29+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-04-12T18:08:16+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-12T09:15:52+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-12T09:15:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2024-04-06T06:53:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"289d1a54-a569-4ea4-9231-1a679fbd50cf","owner":[],"postedDate":"April 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-12-18T19:23:09+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-19 18:43:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4226105","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4226105","identity":"rs-4226105","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}