Abstract

Cesarean section is a recognized intervention in complicated births when the safety of the mother or baby is
compromised. In Uganda, post-operative caesarean care has seen an ascending trend where out of the mothers who
deliver by Cesarean section a number of them develop complications like sepsis attributed to a number of
demographic and health care system related factors. This study sought to gain a better understanding of drivers
and challenges to POC, underlying complications after cesarean section among mothers and staff at ARRH. In total,
328 mothers and 24 staff were recruited for the study. Data was collected, coded, and entered into Epi info version
7, then exported to SPSS version 22.0 for analysis using a structured interviewer/self-administered
questionnaire/checklist. To determine factors associated with POC complications, bivariate and multivariate logistic
regression analyses were performed. To control for confounding, variables with a p - value of 0.2 in a bivariate
analysis were included in a multivariate logistic regression model. To determine the strength of the association,
AOR with corresponding 95 percent confidence intervals (CI) were computed, and a p-value of 0.05 was considered
statistically significant. The majority of the mothers were aged 21 – 25 years 132 (40.3%), had attained primary
level education 187 (57.0%) and had gotten pregnant atleast once 265 (80.8%). The most common minor POC
complications observed amongst the mothers was Mild anemia (25.6%), Mild fever 24h after surgery (19.8%) and
Wound hematoma or infection (11.6%) whereas the most common severe POC complications observed were severe
anemia (11.0%) and Sepsis (6.7%). All (100%) the health care staff were following standard procedures of postoperative
care while attending to mothers and had attended recent Continuing medical education. History of Csection
birth was a significant factor of POC complications AOR [3.6, 95% CI (1.0–9.4)] p-value 0.042. The most
common minor POC complications amongst the mothers receiving POC care were mild anaemia, mild fever 24h
after surgery and wound hematoma or infection whereas the most common severe POC complications observed
were severe anaemia and Sepsis. All healthcare workers that provide POC to mothers followed an institutionalized
standard operating procedure and had updated knowledge through recent continuing medical education. History of
delivery by C-section significantly predisposed mothers to post-operative care complications