Effectiveness of a family-led postnatal care model: A pre-post intervention pilot study in the Ada’a District, Ethiopia

Abstract

Abstract Background Postnatal care is crucial for assessing and improving the health of both mothers and newborns, yet its coverage remains low in Ethiopia. Timely, high-quality postnatal care, especially within the first week after birth, is essential to reduce maternal and neonatal mortality. Family-led postnatal care is an innovative model for reaching postnatal mothers and newborns during the first week after birth. Leveraging self-care principles, mothers, with the support from family and guided by a checklist, perform daily postnatal health checks on themselves and their newborns. This study evaluated the effect of a family-led postnatal care intervention on coverage of postnatal checks within seven days of birth. Methods This study used pre- and post-intervention cross-sectional surveys in four health centers. Eligible postnatal mothers who gave birth in the study health centers were interviewed pre- (November 2022 to January 2023) and post-intervention (February to April 2023) using a structured questionnaire. Bivariate tests and descriptive analyses were used to assess changes in postnatal care coverage over time. Results Surveys were completed with a total of 119 mothers pre-intervention and 110 mothers post-intervention. In the pre-intervention period, 9% (11/119) of mothers and 11% (13/119) of newborns had a postnatal check between 24 and 72 hours after birth, whereas in the post-intervention period this increased to 96% (105/110) mothers and 96% (105/110) newborns (P<0.0001). A similar increase occurred in the proportion of mothers and newborns having postnatal checks between 73 hours and 7 days (3% vs. 96%, P< 0.0001). Compared to pre-intervention, a larger proportion of mothers detected a maternal danger sign during the post-intervention period (6.7% vs 18.2%, P<0.008). Conclusion Family-led postnatal care is a promising self-care model that may increase postnatal checks for mothers and newborns who would not otherwise have received care. Evaluating this model in other settings using a more rigorous design is recommended. Trial registration ClinicalTrials.gov ( NCT05563974 ), first posted on 3 October 2022.