Using Health Belief Model to explain the factors associated with postnatal services utilization among post-delivery mothers in Zanzibar: A cross-sectional study

运用健康信念模型解释桑给巴尔产后母亲产后服务利用相关因素:一项横断面研究

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Abstract

Postnatal period is the crucial period for the survival of mothers and neonates. Utilization of postnatal services has been linked with reduction of maternal and neonatal morbidity and mortality. This study used the Health Belief Model to explain factors that influence postnatal services utilization among post-delivery women in Zanzibar. A community-based cross-sectional study design was employed whereas a total of 395 post-delivery women were randomly selected. The study used the Health Belief components to derive operational variables to explain postnatal services utilization. Structured questionnaires and documentary reviews were used to collect data and analyzed using Statistical Package for Social Sciences Version 20. Binary logistic regression analysis was used to establish factors associated with postnatal utilization. The result revealed that only 115 (29.1%) used postnatal services in Zanzibar. After adjusting the confounders (education level, parity, place of delivery, mode of delivery, and maternal complications), variables of the Health Belief Model which showed a significant relationship were perceived benefit AOR = 10.212 at 95% CI = 2.509-41.567, P = .001 and cues of action AOR = 1.958 at 95% CI = 1.05-3.648, P = .034. Other variables of the Health Belief Model showed increased odds (perceived barriers AOR = 1.748 at 95% CI = 0.81-3.771 and perceived susceptibility AOR = 1.795 CI = 0.561-5.74), but they were not statistically significant. Most of postnatal mothers did not utilize postnatal services during the first month post-delivery. Sensitization campaigns such as educational campaigns are recommended to raise the awareness of postnatal women on the benefits of postnatal checkups within the first month of childbirth and hence improve the utilization.

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