Análise dos factores associados a não adesão às consultas pós-natal em Moçambique

Abstract

Postnatal care constitutes a fundamental stage in the continuity of maternal and child health ser- vices, playing an essential role in preventing postpartum complications and promoting the well- being of both mother and newborn. In Mozambique, adherence to this service remains limited, reflecting socioeconomic inequalities and barriers to healthcare access. The present study aimed to analyze the factors associated with non-adherence to postnatal consultations, using secondary data from the Mozambique Demographic and Health Survey (DHS 2022–23). This is a quanti- tative and cross-sectional study, whose target population comprised women of reproductive age (15–49 years) who had given birth within the five years preceding the survey. The final sample included 3,479 women with complete information on antenatal care, place of delivery, province of residence, household water source, and media exposure. The statistical analysis initially invol- ved descriptive and bivariate procedures, applying the Rao & Scott correction to account for the complex sampling design, followed by multiple logistic regression models to identify the main de- terminants of non-adherence. The results indicated that exposure to mass media (radio, television, or newspapers) reduced the likelihood of non-adherence to postnatal consultations, highlighting the positive role of access to information in promoting healthy behaviors. Significant geographi- cal differences were observed, with higher probabilities of non-adherence in provinces such as Inhambane, Nampula, Niassa, Maputo, and Manica compared to Cabo Delgado. Furthermore, women with an insufficient number of antenatal visits or no antenatal care at all showed a greater likelihood of non-adherence, suggesting a continuity of vulnerability throughout the continuum of care. The attendance of the newborn at postnatal care was associated with higher maternal adhe- rence, reinforcing the interdependence between maternal and child healthcare. Finally, deliveries that occurred in health facilities were linked to greater adherence, underscoring the importance of healthcare institutions in fostering continuity of care.