**Chapter 6 93**

Perspective Chapter: Challenges to Postnatal Care in Sub-Saharan Africa – A Review *by Juliana Yartey Enos, Richard Dickson Amoako, Samuel Kweku Enos,* 

*Beatrice Hayford and Edem Magdalene Tette*

Preface

This book presents a global perspective on contemporary challenges in postnatal care.

Chapter 2, "Barriers and Challenges in the Acceptance and Continuation of Postpartum Intrauterine Contraceptive Device", focuses on barriers and challenges in the acceptance of intrauterine contraceptive devices (IUCDs). These devices range from temporary birth-spacing methods to permanent birth-limiting methods. Despite the advantages of these devices, the acceptance and long-term uptake of IUCDs are lacking, and thus, have little impact on fertility rates in countries that would benefit from such. This is due to provider and logistical barriers in addition to family views. Although the uptake of IUCDs is insufficient for lowering total fertility rates, it is a relevant option for women. However, information, education, and communication (IEC) strategies, counseling,

insertion training, and addressing prejudices about devices are needed.

Chapter 3, "Perspective Chapter: Contemporary Challenges in Postnatal Care in Low- and Middle-Income Countries", discusses neonatal and maternal burdens in low- and middle-income countries. There is a need to enhance maternal well-being and support newborn care, as maternal and neonatal mortality remains high. This objective aligns with the World Health Organization's Sustainable Development Goals, which are hoped to be achieved by the end of 2030. The chapter discusses strategies to reach a positive postnatal outcome, barriers to achieving this outcome, and unmet needs for family planning related to poor postpartum education. Strengthening health systems is essential to improve optimal care for families. These include infrastructure, equipment, water, sanitation, energy, and staff. Postnatal care affects the facility,

Chapter 4, "Breastfeeding by Mothers with Cesarean Section Delivery", discusses Cesarean section deliveries and their association with lower breastfeeding rates. This is partly due to the separation of mother and baby, delay in early initiation of breastfeeding, and lack of milk supply. Therefore, a Cesarean delivery is an obstacle to early

Chapter 1, "Perspective Chapter: Psychosocial Screening and Assessment in the Private Sector in Australia during the Postnatal Period", is a perspective chapter discussing psychosocial screening and assessment in the postnatal period in the private sector in Australia. Postnatal mental health issues have long-term effects on families. Rates of maternal death by suicide are highest in the first year after giving birth. Thus, it is essential to screen and assess women for mental health issues. Women with mental health issues need to be identified early and referred to services to enhance their chance of an optimal outcome for their family. A sustainable model is essential to ensure that an appropriate healthcare professional identifies risks/concerns and engages with women who decline assistance. Timely postnatal psychosocial screening and assessment for private sector women is crucial, but barriers exist. This chapter

discusses possible solutions to these challenges.

household, and community levels.
