scholarly journals Unlocking community capabilities for addressing social norms/practices: Behavioural change intervention study to improve birth preparedness and complication readiness among pregnant women in rural Nigeria

2020 ◽  
Author(s):  
Irene Ifeyinwa Eze ◽  
Chinyere Ojiugo Mbachu ◽  
Edmund Ndudi Ossai ◽  
Celestina Adaeze Nweze ◽  
Chigozie Jesse Uneke
Keyword(s):  
Health Services ◽  
Pregnant Women ◽  
Intervention Study ◽  
Statistical Tests ◽  
Behavioural Change ◽  
Male Partner ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Danger Signs ◽  
Rural Nigeria

Abstract Background Maternal mortality is attributed to combination of contextual factors that cause delay in seeking care, leading to poor utilization of skilled health services. Community participation is one of the acknowledged strategies to improve health services utilization amongst the poor and rural communities. The study aimed at assessing the potentials of improving birth preparedness and complication readiness (BP/CR) using community-driven behavioural change intervention among pregnant women in rural Nigeria. Methods A pre-post intervention study was conducted from June 2018 to October 2019 on 158 pregnant women selected through multi-stage sampling technique from 10 villages. Data on knowledge and practices of birth preparedness and utilization of facility health services were collected through interviewer-administered pre-tested structured questionnaire. Behavioural change intervention comprising of stakeholders’ engagement, health education, facilitation of emergency transport and fund saving system, and distribution of educational leaflets/posters were delivered by twenty trained volunteer community health workers. The intervention activities focused on sensitization on danger signs of pregnancy, birth preparedness and complication readiness practices and emergency response. Means, standard deviations, and percentages were calculated for descriptive statistics; and T-test and Chi square statistical tests were carried out to determine associations between variables. Statistical significance was set at p-value < 0.05 Results The result showed that after the intervention, mean knowledge score of danger signs of pregnancy increased by 0.37 from baseline value of 3.94 (p < 0.001), and BP/CR elements increased by 0.27 from baseline value of 4.00 (p < 0.001). Mean score for BP/CR practices increased significantly by 0.22 for saving money. The proportion that attended ANC (76.6%) and had facility delivery (60.0%) increased significantly by 8.2% and 8.3% respectively. Participation in Community-related BP/CR activities increased by 11.6% (p = 0.012). Conclusion With the improvements recorded in the community-participatory intervention, birth preparedness and complication readiness should be promoted through community, household and male-partner inclusive strategies. Further evaluation will be required to ascertain the sustainability and impact of the programme.

scholarly journals Birth Preparedness and Complication Readiness Practice and Associated Factors among Pregnant Women, Northwest Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yewondwossen Bitew ◽  
Worku Awoke ◽  
Simachew Chekol
Keyword(s):  
Pregnant Women ◽  
Associated Factors ◽  
Group Discussion ◽  
Male Partner ◽  
Northwest Ethiopia ◽  
Postnatal Period ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Danger Signs ◽  
The Status

Background. Little is known about birth preparedness and complication readiness (BPCR) plan in resource limited settings to decrease maternal mortality. Therefore, this study was done to assess the status of BPCR and associated factors among pregnant women in South Wollo, Northwest Ethiopia, by involving 819 pregnant women from March to April, 2014. Data were collected by using pretested interviewer administered questionnaire and analyzed using a computer program of SPSS version 20.00. Results. Pregnant women who were prepared for at least three elements of BPCR were 24.1%. Pregnant women knowing at least three key danger signs during pregnancy, delivery, and postnatal period were 23.2%, 22.6%, and 9.6%, respectively. Women having secondary education and higher were 6.20 (95% CI = [1.36, 28.120]) times more likely to be prepared than illiterates. Women having a lifetime history of stillbirth [5.80 (1.13, 29.63)], attending ANC for last child pregnancy [5.44 (2.07, 14.27)], participating in community BPCR group discussion [4.36 (1.17, 16.26)], and having their male partner involved in BPCR counseling during ANC follow-up [4.45 (1.95, 10.16)] were more likely to be prepared. Conclusions. BPCR was very low and should be strengthened through health communication by involving partner in BPCR counseling.

scholarly journals Knowledge and Practice on Birth Preparedness and Complication Readiness among Pregnant Women in Selected Ward of Biratnager Municipality, Nepal

2019 ◽  
Vol 33 (1) ◽  
pp. 53-66
Author(s):  
Sabitra Subedi
Keyword(s):  
Pregnant Women ◽  
Birth Preparedness ◽  
Care Seeking ◽  
Chi Square ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Danger Signs ◽  
Adequate Knowledge ◽  
Knowledge And Practice ◽  
The Government

 Birth preparedness and complication readiness is the process planning for normal birth and anticipating the action needed in case of an emergency. Promoting birth and emergency planning helps to improve preventive behavior, increase awareness of mothers about danger signs and improvement in care seeking behavior in the case of obstetric complication. A cross sectional descriptive quantitative community-based study was conducted to assess knowledge and practice on birth preparedness and complication readiness among 150 pregnant women of 24 weeks gestation and above in selected wards of Biratnagar with non- probability purposive sampling. The findings of the study showed that 22.7% of the respondents had adequate knowledge on the birth preparedness and complication readiness and 19.8% of respondents had adequate practice. However, the only 9.3% of respondents were prepared for birth complications. Analysis using chi square test identified statistically significant association between knowledge and practice. The study found significant association of knowledge with gravida and weeks of gestation. It seemed there is significant association of practice level with occupation and weeks of gestation and weeks of gestation. The study identified inadequate knowledge and practices on birth preparedness and complication readiness. Thus, the government office, policy makers and partner that are working in maternal health should give due emphasis to preparation for birth and its complication and provide information and education to all pregnant women at community level.

scholarly journals Birth preparedness complication readiness and determinants among pregnant women: a community-based survey from Ethiopia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Teshale Abosie Ananche ◽  
Legesse Tadesse Wodajo
Keyword(s):  
Pregnant Women ◽  
Family Income ◽  
Age Groups ◽  
Health Sector ◽  
Educational Status ◽  
Birth Preparedness ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Danger Signs ◽  
The Government

Abstract Background 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. Methods A Cross-sectional study involving 396 pregnant women was conducted from 1st April to 1st May 2018. Data were collected using a pre-tested structured questionnaire. Descriptive, binary and multiple logistic regression analyses were conducted in SPSS for windows version 20. P values < 0.05 were considered significant. Results Of 361 women interviewed (91% response rate), birth preparedness and complication readiness were present in 24.10% (87/361) of women. Maternal factors, age 18–19 (AOR = 0.18; 95% CI (0.04,0.94)), 20–34 (AOR = 0.40; 95% CI (0.20,0.78)), education, not able to read/write (AOR = 0.36;95% CI (0.15,0.85),read/write (AOR = 0.41;95% CI (0.19,0.89)), Muslim religion (AOR = 0.40; 95% CI (0.18,0.85)) income ETB, < 1000 (AOR = 0.21; 95% CI (0.07,0.67)),1000–2000, (AOR = 0.38; 95% CI (0.19,0.76)), and the mothers’ knowledge on key danger signs of postpartum (AOR = 0.48; 95% CI (0.26,0.90)) were independent predictors of birth preparedness and complication readiness. Conclusions Educational status, age, religion, family income, and knowledge of obstetric danger signs were significantly associated with birth preparedness and complication readiness. The Government and other health sector partners should work to improve women’s education, income, and focus on young age groups on pregnancy danger signs.

scholarly journals “He lets me go although he does not go with me.”: Rwandan women’s perceptions of men’s roles in maternal health

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Germaine Tuyisenge ◽  
Valorie A. Crooks ◽  
Nicole S. Berry
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Critical Time ◽  
Maternal Health Services ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Maternal Health Outcomes ◽  
Men’S Involvement

Abstract Background Increasing men’s involvement in their pregnant partners’ wellness has been reported as one of the ways to improve access to and utilization of maternal health services, including birth preparedness and complication readiness. Men can play meaningful roles in the support systems that pregnant women need to achieve better maternal health outcomes. In Rwanda, the roles that men take vary, resulting in diverse expectations and responsibilities to support the health of women during this critical time. In this study, we aimed to examine the views, perspectives, and experiences of women on men’s involvement in maternal health and how this impacts access and utilization of maternal health services. Methods We conducted 21 interviews with pregnant and recently-pregnant women to gain an understanding of their views on men’s involvement in facilitating their partners’ health during pregnancy. Interviews were conducted across five Rwandan districts in both rural and urban settings of the country. Data analysis was guided by a thematic analysis approach. This started with independent transcript review by the investigators, after which a meeting was held to discuss emergent themes and to identify potential codes. A coding scheme was created and transcripts were coded in NVIVO™ software according to conceptual and practical topics that formed an understanding of men’s involvement in maternal care. Results Three key themes emerged during the analytic process that categorize the specific roles that men play in maternal health: 1) facilitating access to maternal health services, which involves assisting women with getting and or attending appointments jointly with men; 2) supporting women’s decisions, wherein men can support the decisions women make with regard to their maternal healthcare in a number of ways; and 3) evaluating information, including gathering information from multiple sources, especially from community health workers, to assist women with making informed decisions. Conclusion Rwandan men take on three types of roles in supporting women’s maternal health, and their responsibilities are experienced differently by women. Interventions involving men are encouraged to increase their understanding of the implications of their involvement in maternal health without compromising women’s autonomy in decision-making and to promote positive maternal health outcomes.

scholarly journals Are Pregnant Women in Rural Areas Aware of Birth Preparedness? Evidence from a Rural Maternity Hospital in South Karnataka

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Avita Rose Johnson ◽  
Shweta Ajay ◽  
Swathi H. N.
Keyword(s):  
Pregnant Women ◽  
Rural Women ◽  
Rural Areas ◽  
Vaginal Bleeding ◽  
Maternal And Newborn Health ◽  
Birth Preparedness ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Obstetric Danger Signs ◽  
Danger Signs

Background: Birth-preparedness and complication readiness (BPCR) is an evidence based strategy to reduce maternal and perinatal mortality. This study aims to assess awareness of BPCR and its determinants among pregnant women in a rural area of Ramanagara district, Karnataka, South India. Materials and Methods : A cross-sectional hospital-based study among pregnant women availing antenatal care, using the interview schedule from Johns Hopkins Program for International Education in Gynaecology and Obstetrics BPCR Tools and Indicators for Maternal and Newborn Health, with 41 items of BPCR awareness scored one for each correct response. Statistical analysis was performed using independent t-test, One-way ANOVA, Pearson’s correlation, and multi-logistic regression. Results The 331 pregnant women had low mean BPCR awareness score of 9.46 ± 3.61. Commonly mentioned obstetric danger signs were vaginal bleeding, severe weakness, and headache. BPCR awareness was significantly higher among multi-gravidae (P < 0.001), those with previous bad obstetric history (P = 0.002) or complications in the previous pregnancy (P = 0.031), those who registered their pregnancy early (P = 0.018) and those with four or more antenatal check-ups (P = 0.006). Multi-gravid mothers were twice more likely to have higher BPCR awareness than primigravidae. (Odds ratio = 2.41 [1.49–3.34], P < 0.001). Conclusions: Awareness of birth preparedness and obstetric danger signs among women in our study was found to be low. None of the women were aware regarding identifying a blood donor in advance in spite of vaginal bleeding being the most commonly cited danger sign. This study reveals an urgent need to address the lack of awareness of BPCR among rural women during routine antenatal visits or by community-level workers during home visits.

scholarly journals Counselling as a Complementary Maternal and Child Health Intervention in Ghana: The Effect on Pregnancy Outcomes

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1285-1285
Author(s):  
Faith Agbozo ◽  
Abdulai Abubakari ◽  
Francis Zotor ◽  
Albrecht Jahn
Keyword(s):  
Pregnant Women ◽  
Nutrition Education ◽  
Pregnancy Outcomes ◽  
Neonatal Intensive Care ◽  
Binary Logistic Regression ◽  
Birth Preparedness ◽  
Insecticide Treated Nets ◽  
Complication Readiness ◽  
Danger Signs ◽  
Implementation Gaps

Abstract Objectives To identify the main issues midwives reportedly counsel pregnant women on, the influence of counseling on pregnancy outcomes and the implementation gaps. Methods Mixed method design was used. Quantitative data included interviews with 299 pregnant women above 27 gestational weeks randomly recruited from five hospitals in Ghana who had four or more antenatal care (ANC) visits. Their maternal health record books were reviewed for documented counseling sessions. Where half of the recommended topics were discussed, it was considered as adequate counseling (AC). Binary logistic regression was modeled in STATA to estimate the unadjusted odds ratio (OR) of AC on pregnancy outcomes. For the qualitative data, in-depth were conducted with 15 midwives and exit interviews with all the women and analyzed thematically. Results According to the women, the most discussed topics were usage of insecticide-treated nets (60.5%), personal/environmental hygiene (57.5%) and breastfeeding (52.3%). Conversely, the midwives documented discussing mostly nutrition/anaemia (37.6%), danger signs in pregnancy (30.1%) and birth preparedness/complication readiness (29.9%). Most women disliked group counseling and cited non-tailoring of advice. Main implementation gaps were heavy work schedules, inadequate staff, limited time for counseling and hefty documentation. The 45% who were adequately counseled significantly reduced their likelihood for poor dietary intake (OR: 0.54, 95% CI: 0.32–0.90), incidence of malaria (OR: 0.22, 95% CI: 0.06–0.78), preeclampsia (OR: 0.25 CI: 0.06–0.99) and need for neonatal intensive care (OR: 0.29 CI: 0.09–0.94) while increasing the newborn's birth weight (OR: 1.85 CI: 1.08–3.19). Conclusions Strengthening ANC, training midwives to counsel effectively using different skills in varying situations and adopting peer counsellors would facilitate client-centred nutrition education and empower women to take healthier actions, thus promoting behaviour change. Funding Sources None.

scholarly journals Evaluating the Effect of Community Engagement on the Birth Preparedness and Complication Readiness in the Community Level Interventions for Pre-eclampsia (CLIP) Trial in Northern Karnataka, India

2021 ◽  
Author(s):  
Avinash Kavi ◽  
Mai-Lei Woo Kinshella ◽  
Umesh Y Ramadurg ◽  
Umesh S Charantimath ◽  
Geetanjali M Katageri ◽  
...  
Keyword(s):  
Health Services ◽  
Pregnant Women ◽  
Community Engagement ◽  
Health Workers ◽  
Community Level ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Care Seeking ◽  
Complication Readiness ◽  
Community Stakeholders

Abstract Background: Increased birth preparedness and complication readiness can promote timely identification of the need for seeking skilled care and arrival at the appropriate facility for pregnancy complications. Engaging communities can support effective usage of local health services, yet implementation of community engagement programs can be challenging. The objective of the paper is to describe the process of community engagement in northern Karnataka, India and its impact on pre-eclampsia knowledge, birth preparedness and complication readiness, pregnancy-related care seeking and maternal morbidity.Methods: Community engagement was conducted in intervention clusters within the “Community-Level Interventions for Pre-eclampsia” (CLIP) trial in Belagavi and Bagalkote districts in rural Karnataka, India. Community engagement attendance was summarized according to participant group (pregnant women and women of reproductive age, mothers and mothers-in-law, community stakeholders, health workers and others). Pre-eclampsia knowledge, birth preparedness, health services engagement and perinatal outcomes was evaluated within trial surveillance. Outcomes were compared between trial arms using a mixed effects logistic regression model on RStudio (RStudio Inc, Boston, United States). Community feedback notes were thematically analysed on NVivo12 (QSR International, Melbourne, Australia).Results: A total of 1,379 community engagement meetings were conducted with 39,362 participants between November 2014 and October 2016. Community engagement activities may have had an effect on modifying community attitudes towards hypertension in pregnancy and its complications. However, rates of pre-eclampsia knowledge, birth preparedness, health services engagement and maternal morbidities among individual pregnant women were not significantly impacted by community engagement activities in their area.Conclusion: Evaluation of our community engagement program in India demonstrates the feasibility of reaching pregnant women alongside household decision-makers, community stakeholders and health workers. More research is needed to explore the pathways of impact between broad community mobilization to strengthen support for maternal care-seeking and clinical outcomes of individual pregnant women. Trial registration: Clinical Trials.gov, NCT01911494. Registered 30 July 2013, https://clinicaltrials.gov/ct2/show/NCT01911494.

Gambaran Pengetahuan Dan Sikap Ibu Hamil Tentang Tanda Bahaya Selama Kehamilan Di Klinik Romauli

2020 ◽  
Vol 5 (1) ◽  
pp. 90-103
Author(s):  
Lilis Sumardiani
Keyword(s):  
Pregnant Women ◽  
Maternal Death ◽  
Health Workers ◽  
Statistical Tests ◽  
Measuring Instruments ◽  
Chi Square ◽  
Cross Sectional ◽  
Danger Signs ◽  
Health Journal ◽  
Adequate Prenatal Care

The risk of maternal death is higher due to the delay factor, which is an indirect cause of maternal mortality. There are three risks of delay, namely being late in making decisions to be referred to (including being late in recognizing danger signs during pregnancy), being late to the health facilities during an emergency and being late in getting adequate services by health workers. The main causes of maternal deaths in Indonesia are bleeding (28%), eclampsia (24%), and infection (11%). The cause of maternal death can be prevented by adequate prenatal care. This study aims to describe the knowledge of attitudes of pregnant women about danger signs during pregnancy at Romauli ClinicMethod. This type of research is descriptive analytic with cross sectional approach. The total populations are all pregnant women who did the examination at Romauli Clinic from April to May are 120 pregnant women. The number of samples taken is a portion of the population, namely 25 pregnant women who are determined accidentally. The measuring instruments used are questionnaires and questionnaires. Data analysis uses 2x2 chi square test.Result. The results of this study indicate that there is an overview between knowledge and attitudes of pregnant women about danger signs duringElisabteh Health Journal : Jurnal Kesehatan, Vol. V No. 01 (Juni, 2020) : V-01 E-ISSN 2541-4992pregnancy by observing the results of statistical tests obtainead p = 0.003 <α 0.05. Because the significance value is smaller than the real level of 0.05,Duscussion. it can be concluded that there is an overview between the knowledge of the attitudes of pregnant women about danger signs during pregnancy at Romauli Clinic Marelan District Medan City.

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