Modeling the factors associated with early discharge from hospitals after vaginal deliveries in Uganda

Abstract

The aim of this research was to assess the social-economic, obstetrics, and child factors associated with early discharge of mothers of vaginal delivery in Uganda. Self-reported data from the women recode file were extracted from the 2016 Uganda Demographic and Health Survey (UDHS) with a sub sample of 6,701 women aged 15 to 49 whose last birth in the last 5 years preceding the 2016 UDHS survey was vaginal. Chi-square tests were used to establish the relationship between socio-economic factors, obstetrics factors, child factors, and early discharge at bivariate level. At multivariate level, complementary log-log models were used to establish the relationship between socio-economic factors, obstetrics factors, child factors, and early discharge. Regarding social-economic factors, the study found that the odds of an extended stay after vaginal delivery were lower for women aged 25 to 34 (OR=0.855; 95% CI = 0.783–0.934, p = 0.001) and lower for women aged 35 to 44 (OR=0.863; 95% CI = 0.774–0.963, p = 0.008) compared to women aged 15 to 24. For marital status, the odds of a prolonged stay after vaginal deliveries in hospitals were 15.1% lower among women living with a partner (OR = 0.849; 95% CI = 0.727–0.993, p = 0.040) compared to women who were not in a union. In terms of obstetrics factors, the study found that women who gave birth in private facilities were less likely to have a longer hospital stay after vaginal delivery (OR = 0.897, 95% CI = 0.807–0.997, p = 0.044) compared to those who delivered in government facilities. Regarding child factors, the findings showed that there was an increased likelihood of staying longer in the hospital after vaginal delivery among women who gave birth to an average-sized child (OR=1.302; 95% CI=1.190-1.426, P=0.000) and for a small-sized child (OR=1.173; 95% CI=1.046-1.315, P=0.007) compared to those who gave birth to a large sized child. The women with children whose health was checked before discharge were 29.4% more likely to stay longer in the hospital after vaginal delivery (OR=1.294; 95% CI=1.182-1.415, P=0.000) relative to those whose children were not checked before discharge. In conclusion, the risks of early discharge after vaginal delivery increased: among older women, women living with a partner, being from middle and rich income households, giving birth in private health facilities, access to media/radio, giving birth to big-sized children compared with small and average-sized children, child health not checked before discharge, and giving birth to one child. Health workers should ensure that every mother discharged early is scheduled for follow-up care, such as home visits, community-based check-ups, or telehealth consultations.