Utilizing postnatal care (PNC) services shortly after childbirth is fundamental for the health and survival of mothers and their newborns, especially during the vulnerable early days. A recent study conducted on postpartum women in Afghanistan sheds light on the concerning low rates of early postnatal care (EPNC) utilization, indicating substantial barriers related to socioeconomic status, antenatal care accessibility, and the circumstances under which childbirth occurs.
The study, which analyzed data from the Multiple Indicator Cluster Survey (MICS) 2022–2023, reveals only 16.0% of Afghan women accessed EPNC services, defined as receiving the first maternal check within the week following delivery. The findings highlight significant factors influencing whether postpartum women seek timely care, pointing to aspects such as the delivery setting and the use of antenatal care services.
Women who delivered at home were significantly less likely to utilize EPNC services compared to those who gave birth at clinics or hospitals. Specifically, home deliveries were linked to reduced odds of receiving timely maternal checks, with adjusted odds ratios indicating women who delivered at home were 65% less likely to seek EPNC.
Conversely, the study found positive associations between EPNC utilization and several factors: having four or more antenatal care (ANC) visits, higher wealth status, and access to information via radio broadcasts. Women belonging to the highest wealth quintile showed 1.7 times greater odds of utilizing EPNC compared to those from the lowest quintile, underscoring the challenges faced by socioeconomically disadvantaged groups.
This research is timely, particularly as Afghanistan faces deteriorated health service accessibility following the collapse of the international government regime. Achieving goals outlined by global health initiatives, including the United Nations Sustainable Development Goals aimed at reducing maternal and child mortality, requires expansive improvements in early postnatal care coverage.
Several factors came to light as barriers to accessing early postnatal care. The extremely low percentages may be attributed to limited awareness of the necessity for immediate postnatal checks or cultural practices mandatorily restricting movement postpartum. Cultural beliefs surrounding postpartum confinement often prevent women from accessing care, highlighting the need for health communications aimed at educating families about the importance of early maternal assessments.
The researchers used binary logistic regression analysis to dissect these dynamics among 12,578 ever-married women, aged between 15 and 49 years, who had delivered live children, during the survey period. Their efforts seek to position EPNC utilization as both a metric of healthcare access and as part of broader maternal health discourse.
With only 16% of participants accessing postnatal care during the early days, it is clear there is substantial room for improving maternal health systems. Ensuring all women understand the necessity of EPNC and have access to health facilities remains imperative. The study's authors advocate for targeted interventions to bolster EPNC accessibility and uptake, particularly focusing on increasing institutional deliveries and boosting antenatal care services.
To improve outcomes, it is recommended policymakers prioritize enhancing EPNC services for all women, especially those from lower socioeconomic backgrounds. Improving radio-based health messaging may provide additional insights and education for women lacking direct access to maternal health services. The ultimate aim is to reduce maternal and neonatal morbidity and mortality rates across Afghanistan, locations where healthcare inequalities currently persist.