Association of person-centred maternity care during childbirth and future reproductive and health-seeking intentions among adolescents in Lira, Northern Uganda: a cross-sectional survey.

Abstract

Background: Person-centred maternity care (PCMC) is essential for delivering respectful, responsive, and high-quality care during childbirth. However, limited evidence exists on the association between PCMC during childbirth and adolescents’ future reproductive and health- seeking intentions. Objective: To examine the association between PCMC during childbirth and future reproductive and health-seeking intentions among adolescents in Lira, Northern Uganda. Methods: We conducted a community-based cross-sectional study among 560 adolescents aged 14–19 years who had given birth in public primary health facilities between March 2023 and July 2024. PCMC was measured using the validated PCMC scale, while future reproductive and health-seeking intentions were assessed using items adapted from the Community Survey Tool. Data were analysed using descriptive statistics and multivariable logistic regression, adjusting for socio-demographic and obstetric factors. Results: The median age of participants was 18 years (IQR: 18–19). Most adolescents intended to have another child (82%), return to the same facility for future childbirth (83%), and recommend the facility to others (85%). Overall, 77.7% reported moderate levels of PCMC. Adolescents reporting moderate and high PCMC were more likely to intend to return to the same facility for future childbirth (AOR = 2.84, 95% CI: 1.61–5.00; AOR = 5.60, 95% CI: 1.19– 26.43, respectively). Adolescents reporting moderate PCMC were also more likely to recommend the facility to others (AOR = 4.31, 95% CI: 2.46–7.54). Conclusions: Higher levels of PCMC were associated with positive future health-seeking intentions among adolescents. Strengthening adolescent-responsive PCMC may enhance future engagement with skilled childbirth services and contribute to improved maternal health outcomes in low-resource settings.