A THESIS TO BE SUBMITTED TO ARBAMINCH UNIVERSITY DEPARTMENT OF MIDWIFERY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTERS OF SCIENCE IN CLINICAL MIDWIFERY

Abstract

Introduction: Early discharge following childbirth is a common practice, yet its magnitude and associated factors remain insufficiently studied only as national survey using secondary data which missed important facility and provider related factors in Ethiopia, particularly in resource-limited areas like Lanfuro woreda. It is significant public health concern which often linked to inadequate postnatal care and poor maternal and neonatal health. Objective: This study aimed to assess the magnitude of early discharge and associated factors among postnatal mothers in public health facilities of Lanfuro woreda in Silte Zone central Ethiopia 2024. Method: A facility-based cross sectional study was conducted among postnatal mothers who had uncomplicated birth in public health facilities of the study area from May 30 to July 30, 2024. A total of 366 postnatal mothers were selected using systematic random sampling technique. Face to face interview and client chart review using structured questionnaire was used to collect data from participants. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 25 software. In multivariable analysis, significant association was declared at a p-value of <0.05 and the strength of association were measured by 95% confidence interval (adjusted odd ratio). Results: The overall magnitude of early discharge was 74.3 %, (CI=0.69, 0.79) and median length of stay was 18 hours. The mean age of participants was 29.4 years (SD ± 4.18). Multivariable logistic regression analysis identified some significant factors associated with early discharge. Mothers with no formal education were more likely to be discharged early (AOR=3.3, 95% CI=1.1-10.0). Similarly, rural residence (AOR=3.1, 95% CI=1.6-5.8) and spontaneous vaginal delivery (AOR=2.8, 95% CI=1.2-7.1) were associated with increased likelihood of early discharge. Conversely, mothers with at least four antenatal care (ANC) visits (AOR=0.35, 95% CI=0.2-0.7) and those with complications during previous deliveries (AOR=0.38, 95% CI=0.2-0.7) had decreased odds of being discharged early. Conclusion and recommendation: early discharge is high in this setting and is significantly influenced by maternal education, residence, mode of delivery, ANC visits, knowledge on risks of early discharge and previous delivery complications. Recommendation: To ensure adequate postnatal care and monitoring, targeted interventions are needed, particularly for uneducated mothers and those in rural areas.