Post natal care (PNC) refers to routine and emergency care provided in the period after birth until six weeks of age. Studies have identified the first week of life, indeed the first two days, as the most crucial period for post natal care services. This is a critical time to reach both mother and newborn with a package of preventive and health promotions interventions, as well as linking to case management for illnesses. Lack of care during this period may result in death or disability, as well as missed opportunities to promote healthy behaviours that affect women, newborn and children.

A package of post natal care interventions reaching 90 per cent of babies and their mothers, and linking to curative care could prevent an estimated 27 per cent of newborn deaths.
Postnatal care is lacking in many countries and has only recently been highlighted as the lowest coverage gap in the continuum of care.

There are a number of approaches for delivering post natal care; most combine home visits with healthy facility follow up. Home visits with health systems strengthening and been effective and feasible in settings with weak health systems and high neonatal mortality. More frequent, postnatal visits with strong links to referral care are required for sick, small or high-risk newborns.

Routine post natal care provides an opportunity for mothers to receive support to engage in healthy behaviours, such as breast feeding and appropriate cord care.

Mothers can also receive newborn information on family planning, recognition of danger signs in both themselves and their newborn, routine immunisations and encouragement to register the child’s birth. Nigeria newborn mortality rate could be reduced by up to 20 per cent by 2015 by increasing coverage of preventive and health promotive postnatal care alone to 90 per cent of women and newborns. Effective routine postnatal care both improves preventive practices (exclusive breastfeeding, hygiene, warmth) which saves lives especially for sick, small and at risk newborns, and also helps early identification of danger signs.

Nigeria has low routine post natal care coverage, which results in a major gap along the continuum of care. The global recommendation is for the first routine post natal care assessment to be recommended during the first 24 to 48 hours after birth.

Another visit is recommended again within two to three days following birth, within six to seven days and again when the baby reaches six weeks of age.

Current Federal Ministry of Health Policy states that all women who recently delivered, and their newborns should receive post natal care from a skilled provider at one and six weeks after childbirth.

Despite the fact that most maternal and newborn deaths occur within the first week of birth, most health care providers only emphasize the sixth week post natal visit. As a result, only mothers and newborns who survive the critical first few days of the post natal period receive any care at all.

According to the National Demographic and Health Survey 2003, only 23 per cent of mothers who give birth outside a health facility receive a first post natal check within the first two days of birth. More than 70 per cent of mothers who give birth at home do not see any health care provider during the post natal period at all.

There is no explicit policy in Nigeria concerning who provides post natal care. Clearly with over half of births at home, and the long distances to return to the facility even for those born in hospitals, reaching all mothers and newborns in the crucial first days of life is going to require innovation.

An urgent need for operation research relates to the feasibility of visits from community health workers for home births, similar to other countries in Africa and Asia.