{
    "abstract": "Despite high coverage of antenatal care services (89.8%) and facility-based deliveries (79.8%), delayed initiation or lack of follow-up postnatal care (PNC) visits remains a challenge in the Lao People's Democratic Republic (Lao PDR). Follow-up PNC encourages healthy lifestyles and monitoring mothers' and newborns' health to decrease postpartum complications and hospital readmissions. While village health volunteers and workers (VHVs/VHWs) are essential for health promotion in Lao PDR, the extent to which mothers' trust in VHVs/VHWs helps promote better service utilization has not been studied.\nWe investigated the trust levels in VHVs/VHWs among ethnic minority mothers and the influence on the use of facility-based follow-up PNC.\nWe utilized cross-sectional data from July and August 2024, collected as a baseline survey for a quasi-experimental study conducted in 35 villages across the Sepone and Vilabuly districts. We compared the respondents' PNC usage and characteristics using chi-square tests and Fisher's exact tests. Standard binary logistic regression analyses were conducted to\u00a0estimate the effects of various factors on the utilization of facility-based follow-up PNC. Trust in VHVs/VHWs was a construct variable based on their provision of emotional support, relevant information, adequate discussion time, effective care, and the likelihood of future pregnancy-related care.\nThe study enrolled 241 mothers (mean age 24\u00a0years, SD 5.7), including 110 from Sepone and 131 from Vilabuly. Overall, the follow-up PNC coverage rate was 19.0%, and there was no significant difference between Sepone and Vilabuly, despite variations in access to healthcare and engagement with VHVs/VHWs. High trust in VHVs/VHWs was linked to 12.25 times higher odds of utilizing follow-up PNC than low trust (95% CI 2.2-67.8). In addition, having an older child (9-12\u00a0months) and immediate PNC utilization were beneficial for subsequent PNC use. Unexpectedly, contact with VHVs/VHWs during prenatal and/or postnatal periods decreased the odds of utilizing follow-up PNC, with distance to health facilities and adherence to traditional gender norms also having a similar negative effect.\nFacility-based follow-up postnatal care was critically low among respondents; however, increasing trust in VHVs/VHWs may foster improvements. Along with increasing contact frequency, offering quality support to mothers through VHVs/VHWs while emphasizing the complementary nature of community-based and facility-based care could be beneficial. Effective interventions may also include enhancing immediate PNC and tackling physical accessibility challenges, as well as restrictive gender norms through male involvement.",
    "authors": [
        {
            "affiliation": "Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan. adelphahiss@gmail.com.",
            "firstname": "Noud\u00e9hou\u00e9nou Credo Adelphe",
            "initials": "NCA",
            "lastname": "Ahissou"
        },
        {
            "affiliation": "Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan.",
            "firstname": "Manami",
            "initials": "M",
            "lastname": "Uehara"
        },
        {
            "affiliation": "Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan.",
            "firstname": "Daisuke",
            "initials": "D",
            "lastname": "Nonaka"
        },
        {
            "affiliation": "Savannakhet Provincial Health Office, Savannakhet, Lao PDR.",
            "firstname": "Inthanomchanh",
            "initials": "I",
            "lastname": "Vongphoumy"
        },
        {
            "affiliation": "Savannakhet Provincial Health Office, Savannakhet, Lao PDR.",
            "firstname": "Tiengkham",
            "initials": "T",
            "lastname": "Pongvongsa"
        },
        {
            "affiliation": "Sepone District Health Office, Savannakhet, Lao PDR.",
            "firstname": "Khamtoun",
            "initials": "K",
            "lastname": "Ounlienvongsack"
        },
        {
            "affiliation": "Lao Tropical and Public Health Institute, Vientiane, Lao PDR.",
            "firstname": "Khampheng",
            "initials": "K",
            "lastname": "Phongluxa"
        },
        {
            "affiliation": "Lao Tropical and Public Health Institute, Vientiane, Lao PDR.",
            "firstname": "Sengchanh",
            "initials": "S",
            "lastname": "Kounnavong"
        },
        {
            "affiliation": "Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan.",
            "firstname": "Jun",
            "initials": "J",
            "lastname": "Kobayashi"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s41182-025-00730-8",
    "journal": "Tropical medicine and health",
    "keywords": [
        "Follow-up postnatal care",
        "Lao PDR",
        "Trust",
        "Village health volunteers"
    ],
    "methods": null,
    "publication_date": "2025-04-27",
    "pubmed_id": "40287772\n35467813\n26229190\n39060978\n37858190\n36443857\n22299454\n32943043\n24034792\n37474937\n33763223\n35410258\n34011590\n8970487\n35003714\n35462125\n11227840\n34983766\n36168556\n29596636\n35701048\n37640485\n31516363\n27475823\n20937146\n19414443\n33785051\n36252168\n38468218\n25744815\n24547711\n39605079\n37443006\n37189156\n35082489\n36045351\n22798257\n33968883\n32718357\n31852698\n34641891",
    "results": "The study enrolled 241 mothers (mean age 24\u00a0years, SD 5.7), including 110 from Sepone and 131 from Vilabuly. Overall, the follow-up PNC coverage rate was 19.0%, and there was no significant difference between Sepone and Vilabuly, despite variations in access to healthcare and engagement with VHVs/VHWs. High trust in VHVs/VHWs was linked to 12.25 times higher odds of utilizing follow-up PNC than low trust (95% CI 2.2-67.8). In addition, having an older child (9-12\u00a0months) and immediate PNC utilization were beneficial for subsequent PNC use. Unexpectedly, contact with VHVs/VHWs during prenatal and/or postnatal periods decreased the odds of utilizing follow-up PNC, with distance to health facilities and adherence to traditional gender norms also having a similar negative effect.",
    "title": "Effect of trust in village health workers on the\u00a0use of facility-based follow-up postnatal care services\u00a0in two districts in the\u00a0Lao People's Democratic Republic.",
    "xml": "<Element 'PubmedArticle' at 0x788502f5a840>"
}