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Use of postpartum health services in rural uganda: knowledge, attitudes and barriers

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The purpose of this study was to explore the knowledge, attitudes and barriers to use of postpartum care service among rural communities in Uganda. Study was a part of a larger reproductive health evaluation project, and was cross-sectional in nature utilizing qualitative research methods using the narrative inquiry. Two matched rural communities were used in this study; Semuto in Luwero district, and Lwamaggwa in Rakai district. Fifty key informants who were purposefully selected from each study site were interviewed. They included community leaders, political leaders, health care providers, women leaders and community members. One-on-one interviews were conducted with key community informants using an interview guide. The purpose of the interview was explained to each participant, and written informed consent was obtained before the start of the interview. Respondents were allowed to express their views, opinions and observations on several health issues including postpartum health care services. There was a low level of knowledge about postpartum care services among the respondents of the two communities. There was lack of awareness about postpartum care and it’s benefits. The main barriers to use of services were; misconceptions regarding the importance of postpartum care, distance to health facilities, poverty, and health system factors notably; poor facilities, lack of essential drugs, and poor attitudes of health workers. In the effort to improve reproductive health care services, there is an urgent need to improve postpartum services, and make them more accessible and user friendly. The training of providers at all levels is essential, in addition to educating families on the importance of postpartum care services.

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The authors would like to acknowledge the help of all the study participants from the two districts. The exercise would not have been possible without the dedication of all the interviewers and research assistants. Lastly, we would like to thank Dr Jerome Kabakyenga Chair, Department of Community Health for his support, and Dr John Ehiri, Assistant Professor Maternal and Child Health at the School of Public Health University of Alabama at Birmingham for agreeing to review the manuscript, and for his comments. This article was a part of a larger reproductive health evaluation project sponsored by the United States Agency for International Development (USAID), # 617-A-00-00-00-0000-00.

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Correspondence to Sarah K. Nabukera MD, MPH.

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Sarah K. Nabukera is Senior Lecturer Community Health, (currently on study leave at the University of Alabama at Birmingham); Charles Muchunguzi, Lecturer Development Studies; Francis Bajunirwe; Vincent K. Batwala; and Edgar M. Mulogo, Lecturers Community Health, all at Mbarara University of Science and Technology, Mbarara, Uganda. Souleymane Barry was Chief of Party DISH II Project, Kampala, Uganda.

Kim Witte is Senior Program Evaluation Officer, Center for Communication Programs, Johns Hopkins University, Baltimore, Maryland; Celeste Farr, Assistant Professor Department of Communications, North Carolina State University, Raleigh, North Carolina; and Hamisu M Salihu Associate Professor Maternal and Child Health, University of Alabama at Birmingham, USA.

This project was funded by USAID # 617-A-00-00-00-0000-00.

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Nabukera, S.K., Witte, K., Muchunguzi, C. et al. Use of postpartum health services in rural uganda: knowledge, attitudes and barriers. J Community Health 31, 84–93 (2006).

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