Using The Health Belief Model In Explaining Postnatal Services Utilization And The Associated Prevalence Of Neonatal Illnesses In Zanzibar: A Cross-Sectional Study.

ABSTRACT 

Introduction: Postnatal period is the most crucial period for the survival of mothers and neonates. This study, used the Health Belief Model in explaining the association between postnatal services utilization and the associated prevalence of neonatal illnesses in Zanzibar. 

Methods: Community based analytical cross-sectional study design was employed. A total of 395 of post-delivery women and their neonates 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. Descriptive and inferential statistic were applied. 

Results: Majority of the post-delivery mothers (97.2%) delivered in health facilities. 52.7% were female babies and mean birth weight of 2.93. (29.1%) utilized postnatal services.  After adjusting for confounders, perceived benefits towards services (AOR 9.045, 95% C.I 2.160, 37.875) and cues to action (AOR 2.050, 95% C.1 1.085, 3.876) were associated with postnatal utilization. Perceived barriers (AOR 1.579, 95% C.I 0.703, 3.548) and perceived susceptibility (AOR 2.358, 95% C.1 0.703, 7.915) were not associated with utilization. The prevalence of neonatal pneumonia was (8.6%), (5.8%) conjunctivitis, (3.0%) hyperthermia and (0%) diarrhoea. Not utilizing postnatal services (AOR 3.581, 95% C.I 1.636, 7.837) and breastfeed within 1 hour (AOR=0.165; C.I 95%; 0.053; 0.518) were associated with pneumonia. Whereas postnatal utilization lowered the chances for conjuctivitis (AOR 0.314, 95% C.I 0.131, 0.757) and not breastfeeding within 1 hour (AOR= 5.026; C.I 95%; 1.363; 18.534) were associated with conjuctivitis. Furthermore, not utilize postnatal services (AOR=7.105; C.I 95%; 1.796; 28.102) and breast milk only (AOR= 0.121; C.I 95%; 0.031; 0.473) were associated with hyperthermia. 

Conclusions: Postnatal service utilization is low, and is largely a function of mother‟s perceived benefits rather than perceived barriers or susceptibility. And lowered the prevalence of neonatal illnesses. Sensitization should focus on communicating it‟s benefits to increase postnatal uptake and thereby prevent neonatal illnesses.