Acceptability and factors associated with minimum postpartum stay in public health facilities among mothers in Mekelle: a mixed-methods study

Postnatal care in Ethiopia is often neglected. The WHO recommends mothers stay at health facilities for at least 24 hours after delivery, but information on the acceptability is lacking. This study aimed to assess the acceptability and factors associated with minimum postpartum stay at public health facilities among mothers in Mekelle in 2020. A mixed, facility-based cross-sectional study design was employed among 604 mothers from May 14 to June 21, 2020. A multistage sampling technique was used to select study participants, while purposive sampling was used to recruit interviewees. Data were collected using Open Data Kit and exported to SPSS version 25.0 for analysis. In the multivariable regression, statistical significance was declared at a 95% confidence interval and a p-value < 0.05. Qualitative data were coded, categorized, and analyzed thematically. A total of 620 postpartum mothers were enrolled, with 604 responding (97.4% response rate). Of the 604 participants, 527 (87.3%) mothers accepted the minimum recommended postpartum stay. Marital status (AOR = 2.70, 95% CI: 1.14–6.39), pulse rate assessment (AOR = 4.44, 95% CI: 1.34–14.68), confidentiality maintained by health care providers (AOR = 3.03, 95% CI: 1.61–5.69), satisfactory visiting hours for attendants (AOR = 2.48, 95% CI: 1.16–5.29), and mothers’ active participation in care (AOR = 4.61, 95% CI: 1.40–15.15) were identified as independent predictors of acceptability of the minimum postpartum stay. Most interviewees had a positive perception of the minimum postpartum stay. Acceptance of minimum postpartum stay was high, though actual stays fell short of WHO recommendations. Predictors of acceptability included marital status, pulse rate assessment, confidentiality, visiting hours, and active mother’s participation. Interventions to improve facility readiness and family awareness are essential to support optimal postpartum care duration. Further research is needed to explore the effects of early discharge on maternal and newborn health.