Afghanistan Mortality Survey 2010 - Measure DHS

Figure 4.6 Reasons for Not Seeking Care for ProblemsJust Before, During, or After DeliveryPERCEPTION OF SERVICENot necessaryNot customaryWas not life-threateningACCESSIBILITYToo farTransportation problemLack of moneyNo one to accompanyDid not get permissionSERVICE RELATEDGood service not availableBetter service at homeNo female providerInconvenient service hoursDid not know where to goLong waiting hoursAfraid of health facilitiesSECURITYAfraid of bad peopleSecurity reasonsOTHERReligiousOther155546323813121315162757580 10 20 30 40 50 60 7064PercentageAMS 2010Among those who sought care for problems just before, during, and after delivery, nearly twothirdssought care from doctors (65 percent), one-third turned to nurses or midwives (32 percent), and 4percent sought out community health workers (data not shown separately).Eighty-seven percent of women mentioned that their condition improved after treatment for theirproblems just before, during, and after delivery. However, 11 percent mentioned there was no change intheir condition, and 1 percent thought their condition worsened (data not shown separately). A smallproportion of these women who went for treatment were referred to another facility for treatment. Ofthese women, 94 percent were referred to a health facility, of which 57 percent were referred to a publicsector facility, and 37 percent were referred to private sector health facilities (data not shown separately).About one in five women who were referred for treatment did not follow up on the referralprimarily because of the lack of money (61 percent), long distance to the facility (47 percent), andtransportation problems (36 percent).4.3 POSTNATAL CAREA large proportion of maternal and neonatal deaths occur during the 24 hours following delivery.In addition, the first two days following delivery are critical for monitoring complications arising from thedelivery. A postnatal care visit offers an ideal time to educate a new mother on how to care for herself andher newborn. Safe motherhood programs emphasize the importance of postnatal care, recommending thatall women receive at least two postnatal checkups and iron supplementation for 45 days following adelivery. To assess the extent of postnatal care utilization, mothers were asked whether they had receiveda health check after the delivery for the last birth in the five years preceding the survey, when theyreceived the first check, and what type of health provider they saw for postnatal care.Table 4.11 shows that in the five years preceding the survey, 28 percent of women receivedpostnatal care for their last birth. Nearly one in five women received postnatal care within four hours ofdelivery, more than one in five (22 percent) received care within the first 24 hours, and 2 percent ofwomen were seen two days following delivery. Differences by mother’s age, birth order, place ofMaternal Health | 83