Assessment of Integration of Postpartum/postnatal Care in Zambia

Zambia's maternal mortality rate currently stands at 591/100,000, a significant decrease from 729/100,000 in 2002. The postpartum period has been identified as a key area in which substantial improvements must be made. More than half (51%) of postpartum women in Zambia receive no postnatal care. The Health Services and Systems Program undertook a qualitative case study in July of 2009, to determine whether the combined effects of health programming in child health and nutrition (CHN), integrated reproductive health (IRH), and systems strengthening resulted in the integrated delivery of postpartum and postnatal services at the health facility level.

Health facilities that had received systems strengthening, IRH, and CHN program inputs were selected as the nine study sites in three districts. The study sample was comprised of women of reproductive age, who had recently given birth or previously received services related to a prior pregnancy; fathers of infants; community representatives; health service managers and; health care providers. Ten research assistants conducted the 257 facility and community-based interviews/focus group discussions, using specifically developed interview guides. Key results: 1) IRH, CHN, and systems strengthening program inputs have made a positive difference in service delivery and; 2) trained providers have every intention to offer more and better integrated postpartum/postnatal services. .

Study conclusions address training reinforcement, facility configuration, and assuring inclusion of all WHO-recommended essential elements of postpartum and postnatal care services. The analysis can guide governments and partners in low-resource settings in the development of programs to achieve improved maternal and child health outcomes.