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Effect of Postnatal Care Education on Postnatal Care Utilization among Mothers in Nigeria

Abstract

Postnatal care is an essential component of maternal and newborn healthcare and plays an important role in reducing preventable maternal and neonatal morbidity and mortality. The postnatal period, particularly the first few weeks following childbirth, is a critical period during which mothers and newborns may experience complications requiring timely assessment, treatment, counselling, and referral. Postnatal care services may include assessment of maternal and newborn health, identification of danger signs, breastfeeding support, family planning counselling, immunization services, nutritional counselling, mental health support, and education on newborn care and maternal recovery. Postnatal care education provides mothers with information about the importance of postnatal visits, recommended timing of care, maternal and newborn danger signs, breastfeeding, hygiene, nutrition, family planning, and appropriate healthcare-seeking behaviour. In Nigeria, however, utilization of postnatal care services remains affected by factors such as inadequate knowledge, cultural practices, financial constraints, distance to healthcare facilities, transportation difficulties, poor quality of services, limited family support, and misconceptions about the need for care after an apparently uncomplicated delivery. Effective postnatal care education may improve mothers' knowledge of the importance of postnatal services and encourage timely and appropriate utilization. Against this background, this study investigates the effect of postnatal care education on postnatal care utilization among mothers in Nigeria. The study is anchored on the Health Belief Model (HBM), Andersen's Behavioral Model of Health Services Use, and the Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains health-seeking behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding mothers' decisions to utilize postnatal care services. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors and provides a framework for examining how knowledge, accessibility, affordability, and perceived need influence postnatal care utilization. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from postnatal care education may influence healthcare-seeking practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how postnatal care education may influence utilization of postnatal care services among mothers in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from mothers who have recently delivered a baby in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible mothers. Where feasible, selected participants or healthcare facilities will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured postnatal care education covering the importance and timing of postnatal visits, maternal and newborn danger signs, breastfeeding, maternal nutrition, personal hygiene, family planning, newborn care, mental health, and appropriate healthcare-seeking behaviour. Postnatal care utilization will be assessed using indicators such as attendance at postnatal visits, timing of the first postnatal visit, number of recommended postnatal contacts received, utilization of maternal and newborn postnatal services, and compliance with recommended follow-up appointments. Where available, maternal and child health records will be reviewed to validate self-reported utilization. Descriptive statistics will be used to summarize participants' sociodemographic and obstetric characteristics, exposure to postnatal care education, and utilization patterns. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple logistic regression analysis, will be employed to determine the effect of postnatal care education on postnatal care utilization. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and the robustness of the findings. The study anticipates that postnatal care education will have a significant positive effect on postnatal care utilization among mothers in Nigeria. Mothers who receive structured postnatal care education are expected to demonstrate greater knowledge of the importance of postnatal services, recognition of maternal and newborn danger signs, and awareness of recommended postnatal care schedules. Improved knowledge is expected to encourage mothers to attend postnatal visits within the recommended period and complete appropriate follow-up services. Education may also increase mothers' confidence in recognizing complications and seeking timely professional care. However, education alone may not guarantee adequate utilization because mothers may continue to face barriers such as financial difficulties, transportation challenges, distance to health facilities, cultural practices, inadequate family support, inconvenient clinic schedules, and poor quality of postnatal services. Consequently, the effectiveness of postnatal care education is expected to be greater when combined with accessible, affordable, respectful, and high-quality maternal and newborn healthcare services. This study is expected to contribute to the literature on maternal and newborn health, postnatal care, health education, maternal healthcare utilization, and public health in Nigeria by providing empirical evidence on the effect of postnatal care education on postnatal care utilization among mothers. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, hospitals, community health workers, midwives, maternal and newborn health programmes, development partners, and policymakers regarding strategies for improving postnatal care utilization. The study will also provide evidence-based recommendations for strengthening postnatal care education, improving counselling during antenatal and delivery services, establishing effective postnatal reminders and follow-up systems, strengthening community-based maternal health education, improving accessibility of postnatal services, and integrating comprehensive postnatal education into routine maternal and newborn healthcare programmes across Nigeria.

Keywords: Postnatal care education, postnatal care utilization, mothers, maternal health, newborn health, maternal healthcare, health education, postnatal services, maternal and newborn care, public health, Nigeria.