Birth preparedness complication readiness and determinants among pregnant women: a community-based survey from Ethiopia.
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ABSTRACT:
SUBMITTER: Ananche TA
PROVIDER: S-EPMC7574236 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Birth preparedness complication readiness and determinants among pregnant women: a community-based survey from Ethiopia.
Ananche Teshale Abosie TA Wodajo Legesse Tadesse LT
BMC pregnancy and childbirth 20201019 1
<h4>Background</h4>Maternal death related to obstetric complications remains a great challenge in developing countries. Since these complications are not consistently predictable, it is important to plan different preventive approaches to overcome them when. As the information on birth preparedness, complication readiness, and predictors were limited in the study area, we conducted this study.<h4>Methods</h4>A Cross-sectional study involving 396 pregnant women was conducted from 1st April to 1st ...[more]
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Project description:BackgroundMotherhood is a time of anticipation of joy for a woman, her family, and her community. In spite of this fact, it is not as enjoyable as it should be because of numerous reasons. Insufficiency or lack of birth preparedness and complication readiness is the most common reason. The aim of this study was to assess the practice of birth preparedness and complication readiness and associated factors among pregnant women in Tehuledere district, northeast Ethiopia.MethodsA community-based cross-sectional study was conducted in Tehuledere district, northeast Ethiopia. Participants were selected using the multistage sampling technique, and data were analyzed both descriptively and analytically using the binary logistic regression.ResultOut of the total 507 samples, 500 (response rate 98.6%) pregnant women participated in the study. Less than half (44.6%) and (43.4%) of the respondents had knowledge and practice on birth preparedness and complication readiness, respectively. In the multivariate analysis, knowledge of birth preparedness and complication readiness (AOR?=?1.648, 95%CI: 1.073, 2.531), knowledge of danger signs during pregnancy (AOR?=?2.802, 95% CI: 1.637, 4.793), gestational age (AOR?=?3.379, 95% CI: 2.114, 5.401), and antenatal care follow up starting time (AOR?=?2.841, 95% CI: 1.330, 6.068) were significantly associated with the practice of birth preparedness and complication readiness, but pregnant women in rural areas (AOR?=?0.442, 95% CI:0.244, 0.803) were less associated with birth preparedness and complication readiness compared to women in urban settlements.ConclusionThis study identified that poor knowledge, inadequate birth preparedness, and complication readiness were prevalent among mothers in the study area. Government officials, partners, and health care providers working in the areas of maternal and child health should operate together to maximize birth preparedness and complication readiness practices.
| S-EPMC5856365 | biostudies-literature
Project description:BackgroundBirth-preparedness and complication readiness is a comprehensive strategy aimed at promoting the timely utilization of skilled maternal and neonatal health care. Pregnancy-related complications both on the mother and the newborn could be largely alleviated if there is a well-consolidated birth preparedness and complication readiness plan developed during pregnancy and implemented at the time of delivery.ObjectiveTo determine the prevalence of birth preparedness and complication readiness practice (BPCR) and associated factors among pregnant women in North Gondar Zone, Northwest Ethiopia, 2018.MethodsA community based cross-sectional study was conducted among pregnant women in North Gondar Zone from March 2017 to February 2018. A multistage clustered sampling technique was used to enroll a total of 1620 participants. The data were collected by face to face interviews using pretested and semi-structured questionnaires at baseline and following delivery. The data were entered using EPI-data version 3.1 and analyzed using STATA version 14 software. Bivariate and multivariable logistic regression model was fitted to assess factors with BPCR practice. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine the association between covariates and the outcome variable.ResultsFrom a total of 1620 pregnant women only 1523 (94.0%) mothers were followed at the end line. The prevalence of BPCR plan during pregnancy was 66.1% [95% CI: 63.8, 68.5] and the practice at the time of delivery was 73.5% [95% CI 71.3, 75.7]. Of the total respondents who mentioned having a BPCR plan, 76.4% practiced at the time of delivery. Frequency of ANC visits [AOR = 1.97; 95% CI: 1.67, 2.32], larger number of family in the household [AOR = 1.14; 95%CI: 1.00, 1.30], highest wealth asset [AOR = 1.87; 95%CI: 1.16, 3.01], Multigravidity [AOR = 0.30; 95% CI: 0.15, 0.62], husband involvement in decision making [AOR = 2.2; 95% CI: 1.25, 3.82], counseled on BPCR [AOR = 2.35; 95% CI: 1.51, 3.68], were found to be significantly associated with BPCR practice.ConclusionBPCR practice at the time of delivery was higher than previous studies conducted in the country. However, BPCR practice was found to be lower than the standard that every woman should practice the plan at the time of delivery. Intersectoral collaborative interventions required to improve the economic status and living standard of families in the community as well as various awareness creation strategies should be implemented to support women to attend ANC follow-up visits.
| S-EPMC8061992 | biostudies-literature
Project description:BACKGROUND:Birth Preparedness and Complication Readiness interventions have a significant role in the reduction of maternal and neonatal mortality risk. Inadequacy of birth and emergency preparedness were depicted as one of the major reasons for high maternal deaths in sub-Saharan Africa. The main objective of this study was to assess birth preparedness, complication readiness and associated factors among pregnant women. METHODS:A community based comparative cross-sectional study design was conducted among 411 urban and 209 rural respondents who were selected using multi-stage stratified random sampling technique. Quantitative data were collected by interviewer administered questionnaire while qualitative data were collected from purposely selected 54 members of the community by using guiding checklist and analyzed by thematic areas. Birth preparedness and complication readiness was measured using five birth preparedness and complication readiness items then women who scored at least three were considered as well prepared. Bivariate and multivariable logistic regressions were used to examine the association between independent variables and birth preparedness and complication readiness. The result were presented as Odds Ratio at 95% CI. P?<?0.05 ware used to dictate statistical significance. RESULTS:A total response rate of the study was 97.3%. The prevalence of birth preparedness and complication readiness was significantly higher among urban respondents (P?=?25.8%; p?<?0.05). Factors such as history of obstetric complication, knowledge of key danger signs, having favourable attitude towards birth preparedness and complication readiness, starting antenatal care visit within 3 months age of pregnancy, completing at least four antenatal care visits, urban residence, having occupation of government employee or merchant and being in the higher wealth quintile were variables positively associated with birth preparedness and complication readiness. CONCLUSIONS:Prevalence of birth preparedness and complication readiness was low in this study, though significantly higher in urban area. Three-fourth of women planned to attend 4+ antenatal care visits indicating opportunity to counsel them on birth preparedness and complication readiness which increases its prevalence. Health workers should counsel every woman on birth preparedness and complication readiness components during her first antenatal care visit and subsequent visits.
| S-EPMC6998184 | biostudies-literature
Project description:High maternal mortality is a major problem in Nigeria. Birth Preparedness and Complication Readiness will ensure that women can have professional delivery thus reducing obstetric complications. This study assessed the birth preparedness and complication readiness among pregnant women in Osogbo metropolis, a south western community in Nigeria.A community based descriptive cross sectional survey was used. A total of 180 women were selected using multistage sampling technique. Pretested semi-structured interviewer administered questionnaires were used to elicit information about previous obstetric history, knowledge of the danger signs of pregnancy and level of birth preparedness. Composite score and mean were computed. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 17. P-value was set at < 0.05.The mean age was 26.11 ± 3.63 years. A total of 51.1% were carrying their 2nd or 3rdpregnancies. A total of 70.8% were aware of danger signs in pregnancy and the commonest danger sign mentioned was bleeding per vagina. In all, 82.1% were well prepared for birth. Being in the younger age group (p = 0.026), being more educated (p < 0.0001) and being aware of danger signs in pregnancy (p < 0.0001) was more significantly associated with being well prepared.The respondents were well prepared for birth with the younger women, educated ones and those knowledgeable of danger signs being better prepared. Continuous education about the Birth Preparedness and Complication Readiness should be sustained in order to maintain and improve women's preparedness.
| S-EPMC5554692 | biostudies-other
Project description:ObjectiveThe objective of this study was to determine the level of birth preparedness and complication readiness (BPCR) and associated factors among semi-pastoral pregnant women in southern, Ethiopia.ResultThis dataset contains the full data collected from 746 pregnant women. Birth preparedness and complication readiness among women in southern Ethiopia was 27.1%. The main predictors for BRCP were attending formal education (AOR?=?4.65, 95% CI 2.45-8.63), husband occupation [merchant (AOR?=?3.83, 95% CI 1.52-9.64)], spouse attending formal education (AOR?=?3.35, 95% CI (1.83-6.14), ANC visits >?4 times (AOR?=?17.78, 95% CI 7.11-44.47). In addition, knowledge of women at least two danger signs during pregnancy, delivery and after delivery (AOR?=?3.32, 95% CI 1.64-6.69), (AOR?=?3.13, 95% CI 1.58-6.20) and (AOR?=?3.75, 95% CI 1.93-7.28) respectively were significantly associated with BPCR. In conclusion, the proportion of BPCR among women in southern Ethiopia was found to be low.
| S-EPMC6030774 | biostudies-literature
Project description:BackgroundBirth preparedness and complication readiness (BP/CR) is an intervention designated by the World Health Organization (WHO) as an essential element of the antenatal (ANC) package with a concept of a global strategy to reduce maternal mortality. In Ethiopia, the proportion of pregnant women preparing for birth and related complications has remained low. Whereas, the need for additional study is indicated to add more evidence to the country's efforts to end preventable maternal death.MethodsA facility-based cross-sectional study was conducted from March 01 to May 01, 2021. A systematic random sampling technique was applied to recruit 422 pregnant women. Bivariable and multivariable binary logistic regression was fitted to identify factors associated with BP/CR practice. Variables with a p-value ≤ 0.25 on the bivariable analysis were included in multivariable analysis. Adjusted odds ratios (AOR) with the respective 95% confidence interval (CI) and a p-value <0.05 was used to set statistically significant variables in the multivariable analysis.ResultsA total of 414 pregnant women have participated in the study. The overall BP/CR practice level was 44.9% (95% CI: 40.1, 49.7). Preconception care utilization (PCC) (AOR = 2.31; 95% CI:1.38-3.86), urban residents (AOR = 2.00; 95% CI:1.21-3.31), knowledge of BP/CR (AOR = 2.29; 95% CI:1.27-3.47), knowledge of danger signs during pregnancy (AOR = 2.05; 95% CI:1.21-3.47), knowledge of danger signs in newborns (AOR = 2.06; 95% CI:1.21-3.47), starting ANC visits in the 1st and 2nd trimester (AOR = 2.52; 95% CI:1.40-4.52), number of ANC visit ≥ three (AOR = 1.66; 95% CI;1.01-2.74), knowing Expected Date of Delivery (EDD) (AOR = 3.71; 95% CI:2.01-6.82), and joint decision-making on obstetric services (AOR = 3.51; 95% CI;1.99-6.20) were factors significantly associated with BP/CR practice.ConclusionBased on the WHO standard, this study revealed a low level of BP/CR practice among pregnant women, with only less than half of women adequately prepared for childbirth and its complications. Moreover, it has been shown that BP/CR practice is influenced by socio-economic, maternal knowledge, and health service-related factors. Therefore, improving the status of BP/CR practice by expanding awareness creation opportunities, strengthening PCC and early ANC initiation by improving pregnant women's understanding, and promoting joint decision-making on obstetric services are recommended.
| S-EPMC9612452 | biostudies-literature
Project description:With an aim to prevent adverse pregnancy outcomes, 'birth preparedness and complication readiness' (BP/CR) promotes timely access to skilled maternal and neonatal services. Objective of this study was to assess implementation of BP/CR among pregnant women admitted with obstetric emergencies in rural Rwanda.A cross-sectional study among pregnant women who were referred to Ruhengeri hospital between July and November 2015. The 'Safe Motherhood questionnaire' as developed by Jhpiego's Maternal and Neonatal Health Program was used to collect data. Women were asked to mention key danger signs and respond as to whether they had identified: (A) skilled birth attendant, (B) location to give birth, (C) mode of transport, (D) money to cover health care expenditure. Women who answered 'yes' to three or four items were labeled 'well prepared'. Multivariate logistic regression analysis was conducted to compare the 'well prepared' and 'less prepared'.With regard to complication readiness, out of 350 women, 296 (84.6%), 271 (77.4%) and 288 (82.3%) could mention at least one key danger sign during pregnancy, labor and postpartum respectively, but only 23 (6.6%) could mention three or more key danger signs during all three periods. With regard to birth preparedness, 46 (13.1%) women had identified a skilled birth attendant, 68 (19.4%) birth location, 76 (21.7%) mode of transport, and 306 (87.4%) had saved money for health care costs. Seventy-eight women (22.3%) were 'well prepared', associated factors being first time pregnancy (adjusted Odds Ratio (aOR)?=?3.2; 95% CI; 1.2-5.8), knowledge of at least two danger signs (aOR?=?2.8; 95% CI; 1.7-3.9) and having been assisted by a community health worker at the antenatal clinic (aOR?=?2.2, 95% CI; 1.3-3.7).Knowledge of obstetric danger signs was suboptimal and birth preparedness low. We recommend review of practices regarding health promotion in antenatal care, taking care not to exclude multiparous women from messages related to birth preparedness, and do promote use of community health workers to enhance effectiveness of BP/CR.
| S-EPMC5977552 | biostudies-other
Project description:Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh.To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices.A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis.Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1), practice clean cord care (OR = 1.3, CI: 1.0-1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2) or their newborn (OR = 2.6, CI: 2.1-3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6).Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low performing districts in Bangladesh.
| S-EPMC5724858 | biostudies-literature
Project description:BACKGROUND:Increasing the level of birth preparedness and complication readiness (BP/CR) is one of the key interventions to promote optimal utilization of skilled maternal health services. It is therefore essential to determine the women's ability to recognize the danger signs and the level of BP/CR. This information can be used to design more effective health interventions. OBJECTIVES:This study was conducted to determine the knowledge in recognition of maternal complications, and the level and factors associated with BP/CR in rural Matlab, Bangladesh. METHODS:A community-based cross-sectional survey was conducted from June- October 2015 on a randomly selected 2262 women who delivered live or stillbirth during the year 2014. A pretested and structured questionnaire was used for data collection. Descriptive and analytical statistical methods were used. RESULTS:The proportion of study participants with "good knowledge", measured by the ability to recognise three or more danger signs, in pregnancy and delivery were 26% and 23%, respectively. Out of four BP/CR components, about 15% women saved money, 12% women identified facility for delivery, 9.6% women planned to deliver by skilled birth attendant and 5.3% of women arranged transport. About 12% of women were "well prepared", measured by planning of at least two components, for skilled childbirth and emergency obstetric complications. In the multivariable logistic regression analysis, asset index, antenatal care (ANC) visits and knowledge of danger signs during pregnancy and delivery were associated with BP/CR. The adjusted odds ratio (OR) of "well prepared" was 4.09 (95% confidence interval [CI]: 2.45-6.82) among women with an asset index of five (richest), compared with women in the asset index of one (poorest). The odds of "well prepared" was six times (OR 5.98, 95% CI: 3.85-9.28) higher for women with four or more ANC visits, compared to women with none or one ANC visit. In comparison to women with "poor knowledge" on maternal danger signs during pregnancy and delivery, the odds ratio of "well prepared" among women with good knowledge during pregnancy and in delivery were 1.95 (95% CI: 1.44-2.63) and 1.74 (95% CI: 1.28-2.36), respectively. CONCLUSION:The study revealed a low level of maternal knowledge of danger signs and BP/CR among pregnant women. Further, low socioeconomic status, fewer ANC visits and poor knowledge in recognition of dangers signs on maternal health were associated with low BP/CR. More emphasis should be placed on the quality of information offered to the pregnant women during the prenatal contact and women from low socio-economic gradient should be prioritized to optimize the impact of future BP/CR interventions.
| S-EPMC6296737 | biostudies-literature
Project description:BackgroundDelayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.MethodsWe conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016-2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.ResultsOnly 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14-2.20, secondary: aOR: 2.24, 95% CI: 1.39-3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15-2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80-2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93-2.67), postpartum (aOR: 2.69, 95% CI: 1.24-5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13-1.78).ConclusionOverall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
| S-EPMC7574438 | biostudies-literature