Improving postnatal checkups for mothers in West Africa: A multilevel analysis

ABSTRACT

This study examined multilevel factors related to postnatal checkups for mothers in selected West African countries. The study analyzed data from Demographic and Health Surveys (DHS) for five West African countries: Sierra Leone (2013), Cote d’Ivoire (2012), Guinea (2012), Niger (2012), and Liberia (2013). The weighted sample sizes were 2125 (Cote d’Ivoire), 2908 (Guinea), 1905 (Liberia), 5660 (Niger), and 3754 (Sierra Leone). The outcome variable was maternal postnatal checkups. The explanatory variables were community and individual/household characteristics. With the use of Stata 12, the chi-square statistic and multilevel mixed-effects logistic regression were applied. More than two-thirds of respondents in Guinea and Niger did not receive a postnatal checkup after their last birth, while in Cote d’Ivoire, Liberia, and Sierra Leone, more than half of respondents received a postnatal checkup after their last childbirth. Community characteristics accounted for the following variations in postnatal checkups: 33.9% (Cote d’Ivoire), 37.2% (Guinea), 27.0% (Liberia), 33.5% (Niger), and 37.2% (Sierra Leone). Community factors thus had important relations to use of postnatal care in West Africa. Interventions targeting more community variables, particularly community education and poverty, may further improve postnatal care in West Africa.

KEYWORDS:

• Checkup
• childbirth
• maternal health
• multilevel
• postnatal
• West Africa

Acknowledgments

We appreciate MEASURE/DHS for granting access to the datasets. We thank the University of the Witwatersrand, South Africa, for providing resources and facilities that enhance preparation of the manuscript. We also appreciate Professor Clifford Odimegwu, Dr. S. A. Adedini, and Dr. J. O. Akinyemi for providing tutorials and materials on multilevel modeling.