Caring After Birth: Exploring The Realities of Post-Natal Care for Mothers and Infants in Nyakach, Kisumu County
Abstract:
Postnatal care (PNC) is a critical but often neglected component of maternal and newborn health services, especially in low-resource settings like Nyakach sub-county in Kisumu County, Kenya. Despite evidence that many maternal and neonatal deaths occur within 42 days after birth – and notably within the first week—PNC coverage and quality remain inadequate. This qualitative study aimed to explore the realities of PNC utilization in Nyakach subcounty, highlighting community level factors associated with uptake and document strategies to improve practice. Data was collected through follow-up surveys with 95 postnatal women, and 23 focus group discussions involving 460 postnatal women across 15 community units. Thematic analysis revealed low utilization of PNC services and disparities in service content despite high (98 pc) facility-based deliveries. Only 77pc of women received PNC information before discharge. Information was often provided in technical language that limited comprehension. Cultural practices, including postpartum seclusion, reliance on traditional birth attendants, coupled with socio-economic constraints such as financial barriers, poor transport infrastructure, and gender power dynamics, significantly impeded timely PNC uptake. Negative experiences with healthcare workers and fragmented service delivery further discouraged follow-up visits. Mental health support and danger sign awareness were notably deficient. The role of community health providers emerged as vital in bridging access gaps, providing home-based education, counseling, and follow-up. Nonetheless, systemic challenges such as understaffed facilities, inadequate training, poor integration of services, and weak referral systems persist. The study underscores the need for comprehensive strategies to improve both supply and demand aspects of PNC by strengthening health facility capacity, enhancing community health worker skills, improving communication of health information tailored to local contexts, and addressing socio cultural barriers. Targeted interventions should particularly focus on younger mothers and remote areas to advance equitable access. Strengthening community engagement and leveraging social networks can promote culturally sensitive PNC practices, ultimately contributing toward improved maternal and neonatal health outcomes and progress toward Sustainable Development Goal 3 in Kisumu County and similar settings.
