Feasibility, acceptability, and sustainability of family-led postnatal care model: a multi-site mixed study in Ada’a District, Ethiopia

Design

The study applied a post-intervention mixed-method design drawing on cross-sectional survey, data review from registers and checklists, and in-depth interviews and key-informant interviews from February–April 2023.

Setting

The study was conducted in four health centers and catchment areas in Ada’a District, Oromia Region, Ethiopia.

Participants

The quantitative survey included 110 postnatal women. The qualitative components included in-depth interviews with postnatal women, husbands/partners, and family members and key-informant interviews with midwives/nurses, health extension workers, home care kit custodians, and health managers.

Intervention

Family-led postnatal care is a self-care innovation for postnatal women and newborns during their first week of life. In the model, a midwife or nurse invites family members to attend the discharge and assesses the mother and newborn using a pictorial checklist. The checklist is given to the families with guidance on retrieving a home care kit (containing blood pressure monitor, thermometer, and health-education booklet) from a volunteer community custodian. At home, families use the checklist and kit to assess the health of the postnatal mother and newborn for six days, returning the completed checklist and kit to the custodian afterwards.

Main outcome measures

The outcome measures are feasibility, acceptability, and sustainability of the family-led postnatal care model.

Results

Participants at facility and community levels felt that family-led postnatal care was feasible and acceptable due to the easy-to-use materials for varied literacy levels, its influence on spouses/partners and families to support mothers, and its empowerment of women to recognize signs that require care-seeking. All health centers continued the family-led postnatal care model, and most kits were functional six months after the end of project support.

Conclusions

Our results indicate that family-led postnatal care is a promising approach that can be tested and scaled in other settings.

• Trial registration

ClinicalTrials.gov ( NCT05563974 ).

Summary boxes

• What is already known on this topic

  • In Ethiopia, 80% of mothers and newborns receive no postnatal care.

  • Innovative models are needed to deliver postnatal care for mothers and newborns in Ethiopia.

• What this study adds

  • This family-led postnatal care model’s culturally sensitive, low-literacy tools, and integration into the healthcare system have demonstrated significant feasibility, acceptability, and early signs of sustainability for a self-care approach to postnatal care in Ethiopia’s rural, resource-limited settings.

• How this study might affect research, practice or policy

  • Family-led postnatal care, a self-care model for postnatal care, is a promising approach to test and scale in other settings.