title: Low utilization of postnatal care: searching the window of opportunity to save mothers and newborns lives in Islamabad capital territory, Pakistan.
abstract: BACKGROUND
  Each year an estimated 289,000 maternal deaths occur worldwide; of which 50 % of maternal deaths occur around labor, delivery and immediate postpartum period. Postnatal care (PNC) is crucial but relatively neglected component in the continuum of care, and hence a missing link toward safe motherhood. Despite the significant improvement in child health and safe motherhood interventions, maternal mortality ratio, perinatal mortality and neonatal mortality still remain a challenge in achieving the Millennium Development Goals 4 and 5 in Pakistan.
  
  
  METHODS
  This was a descriptive cross sectional study carried out in the four union councils of Islamabad capital territory, to understand the determinants of postnatal health care seeking. The study sample comprised 225 postpartum women with a child 0 to 1 month of age, and the health care providers from both public and private sector. A pre-tested semi-structured questionnaire was used for data collection. One focus group discussion with health care providers was conducted, using open ended questions guide.
  
  
  RESULTS
  Only 30 % women received PNC; amongst which 68 % went to a government health facility. According to the health service providers, 90 % women are not interested in PNC, and that is because they lack awareness, face mobility and transportation issues, and cannot afford the cost of health care. Besides many other determinants, women's education was significantly associated with the PNC utilization.
  
  
  CONCLUSIONS
  More robust and culturally sensitive campaign on importance of PNC must be thought out by the national MNCH program to inform the less literate and peri urban inhabitants of Islamabad. Health providers ought to be sensitized and trained for promoting PNC to save maternal and newborn lives.
authors.affiliation: Department of Health Systems and Policy, Health Services Academy, Park Road, Chak Shahzad, Islamabad, 44000, Pakistan. drnighatsultana@gmail.com.
authors.forename: Nighat
authors.initials: N
authors.lastname: Sultana
authors.affiliation: Department of Health Systems and Policy, Health Services Academy, Park Road, Chak Shahzad, Islamabad, 44000, Pakistan. shaikh.babar@gmail.com.
authors.forename: Babar Tasneem
authors.initials: BT
authors.lastname: Shaikh
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010154:Pakistan; D011181:Postnatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult