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    Factors affecting the utilisation of postpartum care among young mothers in Bangladesh
    (© 2011 Blackwell Publishing Ltd., 2011-03) Mosiur Rahman, Md.; Haque, Syed Emdadul Mdadul; Zahan, Sarwar
    This article addresses the hypothesis that predisposing, enabling and need factors of households influence utilisation of postpartum care among the young mothers according to the timing and type of providers. To reach our goal Bangladesh Demographic and Health Survey of 2007 data (n=2376) were used. Findings revealed that only one-third of the young mothers received postpartum care. Postpartum care by medically trained personnel and within the most critical period (within 48h after delivery) was found to be very low (25.5 and 16.6%). Regarding postpartum morbidities, only one-fifth to one-half of the women reporting a complication consulted medically trained providers. Indeed, between one third and two thirds did not seek any postpartum care. The highest percentages contacting healthcare providers were for convulsions and the lowest was when the baby's hands or feet came first. The stronger influence of the mother's education and antenatal care on the utilisation of postpartum care is consistent with findings from other studies. Concern of the husband or family about pregnancy complications showed a significant and positive impact on the utilisation of postpartum care. Multivariate analysis showed that mother's age at delivery, residence, education, antenatal care, place of delivery, wealth, husband's occupation, husband's concern about pregnancy complications and mother's permission to go to a health centre alone were likely to affect utilisation of postpartum care services. The results indicate urgent needs in Bangladesh for an awareness-raising program highlighting the importance and availability of postpartum care; for strategies to improve the availability and accessibility of antenatal care services and skilled birth attendance, including focused financial support; for women's education to be given high priority; and to enable women to exercise their rights to control their freedom of movement, own health care and access to economic resources.
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    Noninstitutional births and newborn care practices among adolescent mothers in Bangladesh
    (© 2011 JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2011) Rahman, Mosiur Mosiur; Haque, Syed Emdadul Mdadul; Zahan, Sarwar; Islam, Ohidul; BRAC Institute of Educational Development
    Objective: To describe home-based newborn care practices among adolescent mothers in Bangladesh and to identify sociodemographic, antenatal care (ANC), and delivery care factors associated with these practices. Design: The 2007 Bangladesh Demographic Health Survey, conducted from March 24 to August 11, 2007. Setting: Selected urban and rural areas of Bangladesh. Participants: A total of 580 adolescent women (aged 15-19 years) who had ever been married with noninstitutional births and having at least one child younger than 3 years of age. Methods: Outcomes included complete cord care, complete thermal protection, initiation of early breastfeeding, and postnatal care within 24 hours of birth. Descriptive statistics and multivariate logistic regression methods were employed in analyzing the data. Results: Only 42.8% and 5.1% newborns received complete cord care and complete thermal protection. Only 44.6% of newborns were breastfed within 1 hour of birth. The proportion of the newborns that received postnatal care within 24 hours of birth was 9%, and of them 11% received care from medically trained providers (MTP). Higher level of maternal education and richest bands of wealth were associated with complete thermal care and postnatal care within 24 hours of birth but not with complete cord care and early breastfeeding. Use of sufficient ANC and assisted births by MTP were significantly associated with several of the newborn care practices. Conclusions: The association between newborn care practices of the adolescent mothers and sufficient ANC and skilled birth attendance suggest that expanding skilled birth attendance and providing ANC may be an effective strategy to promote essential and preventive newborn care.