Abstract / Summary
Abstract Background To assess the level of knowledge, attitude, and practice regarding postpartum care among women who delivered via cesarean section at Ayder Comprehensive Specialized Hospital (ACSH), and to identify factors associated with these outcomes. Methods An institution-based cross-sectional study was conducted from April 2023 to July 2023 at ACSH, a tertiary-level comprehensive specialized referral hospital in Mekelle, Northern Ethiopia. A total of 412 postpartum women and 421 corresponding neonatal records were evaluated. Data were collected using an interviewer-administered, pretested Open Data Kit (ODK) questionnaire. The primary outcomes were good knowledge, favorable attitude, and good maternal postpartum care practice. Neonatal physical examination practice was also assessed. Adjusted odds ratios (AOR) with 95% confidence intervals (CIs) were reported. Results The majority of mothers had good postpartum care knowledge (323/412, 78.4%) and a favorable attitude toward postpartum care (397/412, 96.4%). Maternal care practice in the maternity ward was good in 240 of 412 mothers (58.3%), whereas neonatal physical examination practice was good in only 56 of 421 neonates (13.3%). Educational status was the strongest independent predictor of good knowledge (AOR = 0.02, 95% CI 0.00–0.12, p < 0.001 for no formal education; AOR = 0.10, 95% CI 0.03–0.30, p < 0.001 for elementary education, versus college and above), while four or more antenatal care (ANC) visits increased the odds of good knowledge (AOR = 4.18, 95% CI 1.03–17.02, p = 0.046). Partner's educational status, number of ANC visits, and place of ANC visits were significantly associated with good maternal practice. Educational status was also associated with attitude score (p = 0.008). Conclusions Knowledge and attitude of mothers regarding postpartum care after cesarean delivery at ACSH were generally good, but neonatal examination and some postpartum counseling practices were inconsistent. Maternal and partner educational status and antenatal care attendance were important determinants of knowledge and practice. These findings highlight gaps in routine maternity ward practice that warrant quality-improvement initiatives.