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

ObjectivesThis study aims to assess the feasibility, acceptability, and sustainability of the family-led postnatal care model. DesignThe 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. SettingThe study was conducted in four health centers and catchment areas in Adaa District, Oromia Region, Ethiopia. ParticipantsThe 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. InterventionFamily-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 measuresThe outcome measures are feasibility, acceptability, and sustainability of the family-led postnatal care model. ResultsParticipants 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. ConclusionsOur results indicate that family-led postnatal care is a promising approach that can be tested and scaled in other settings. * Trial registrationClinicalTrials.gov (NCT05563974). Summary boxesO_LIWhat is already known on this topic O_LIIn Ethiopia, 80% of mothers and newborns receive no postnatal care. C_LIO_LIInnovative models are needed to deliver postnatal care for mothers and newborns in Ethiopia. C_LI C_LIO_LIWhat this study adds O_LIThis family-led postnatal care models 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 Ethiopias rural, resource-limited settings. C_LI C_LIO_LIHow this study might affect research, practice or policy O_LIFamily-led postnatal care, a self-care model for postnatal care, is a promising approach to test and scale in other settings. C_LI C_LI