scholarly journals What are the essential components of Antenatal Care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation.

2021 ◽  
Author(s):  
Hannah McCauley ◽  
Kirsty Lowe ◽  
Nicholas Furtado ◽  
Viviana Mangiaterra ◽  
Nynke van den Broek
Keyword(s):  
Antenatal Care ◽  
Partner Violence ◽  
Monitoring And Evaluation ◽  
Birth Preparedness ◽  
Mortality And Morbidity ◽  
Signal Functions ◽  
Danger Signs ◽  
Health And Wellbeing ◽  
Data Collection And Analysis ◽  
Essential Components

Background Antenatal Care (ANC) is one of the key care-packages required to reduce global maternal and perinatal mortality and morbidity Objectives To identify the essential components of ANC and develop signal functions Search strategy MESH headings for databases including Cinahl, Cochrane, Global Health, Medline, PubMed, and Web of Science Selection Criteria Papers and reports on content of ANC published from 2000-2020 Data collection and Analysis Narrative synthesis of data and development of signal function through 7 consensus-building workshops with 184 stakeholders Main Results A total of 221 papers and reports are included from which 28 essential components of ANC were extracted and used to develop 15 signal functions with the equipment, medication and consumables required for implementation of each. Signal functions for the prevention and management of infectious diseases (malaria, HIV, tuberculosis, syphilis and tetanus) can be applied depending on population disease burden. Screening and management of pre-eclampsia, gestational diabetes, anaemia, mental and social health (including intimate partner violence) are recommended universally. Three signal functions adress monitoring of foetal growth and wellbeing and identification and management of obstetric complications. Promotion of health and wellbeing via education and support for nutrition, cessation of substance abuse, uptake of family planning, recognition of danger signs and birth preparedness are included as essential components of ANC. Conclusions New signal functions have been developed which can be used for monitoring and evaluation of content and quality of ANC. Country adaptation and validation is recommended.

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Micheal A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Background: Delayed 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.Methods: We 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.Results: Only 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).Conclusion: Overall, 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.

scholarly journals Birth Preparedness and Its Association with Skilled Birth Attendance and Postpartum Checkups among Mothers in Gibe Wereda, Hadiya Zone, South Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Yohannes Lakew ◽  
Fasil Tessema ◽  
Chernet Hailu
Keyword(s):  
Antenatal Care ◽  
Educational Status ◽  
Skilled Birth Attendance ◽  
Cross Sectional Study ◽  
Birth Preparedness ◽  
Sampling Frame ◽  
Cross Sectional ◽  
Danger Signs ◽  
Birth Attendance ◽  
Three Delays

Background. Birth preparedness program was designed to enhance skilled birth attendance and postpartum checkups of women in a developing country to reduce the three delays that lead women and neonates to death and disability. However, the relationship between birth preparedness with skilled birth attendance and postpartum checkups among mothers is not well studied. Therefore this study is intended to assess the association between birth preparedness and skilled birth attendance and postpartum checkups. Methods. A community based cross-sectional study was conducted from March to April 2014. Eight out of 22 Kebeles were selected using probability proportional to size sampling method. Seven hundred and forty-five mothers were selected randomly from the sampling frame, generated from family folders obtained from health posts. Data was collected using pretested questionnaire by face-to-face interview. Data was entered into EpiData version 3.1 database and analyzed by SPSS version 16. Result. Out of 745 sampled mothers 728 (97.7%) participated in the study. One hundred and twelve (15.4%) and 128 (17.6%) mothers got skilled birth attendance and received postpartum checkups for their last child, respectively. Birth preparedness, educational status of women and their husbands, and antenatal care visits of mothers were found to be predictor of skilled birth attendance and postpartum checkups. Mothers well prepared for child birth were 6.7 times more likely to attend skilled birth attendance [AOR = 6.7 (2.7–16.4)] and 3 times more likely to follow postpartum checkups [AOR = 3.0 (1.5–5.9)] than poorly prepared mothers, respectively. Travel time to reach the nearest health facility was found as predictor for postpartum checkups of mothers; mothers who travel ≤ 2 hours were three times more likely to follow postpartum checkups than mothers who travel > 2 hours (AOR (95% CI) = 3.4 (1.5–7.9)). Conclusion and Recommendation. Skilled birth attendance and postpartum checkups were low. Encouraging women to attend recommended antenatal care visits and providing advice and education on birth preparedness and obstetric danger signs are important interventions to increase skilled birth attendance and postpartum checkups.

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Michael A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Background Delayed 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. Methods We 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. Results Only 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). Conclusion Overall, 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.

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Micheal A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Introduction: Delayed 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.Methods: We 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.Results: Only 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).Conclusion: Overall, 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.

scholarly journals Does knowledge of danger signs influence use of maternal health services among rural women? Findings from Babati Rural district, Northern Tanzania.

2019 ◽  
Author(s):  
Edwin Joseph Shewiyo ◽  
Minael G Mjemmas ◽  
Faidha H Mwalongo ◽  
Ester J. Diarz ◽  
Sia E. Msuya ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Rural Women ◽  
Rural District ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Maternal And Newborn

Abstract Background Increasing knowledge on obstetric danger signs (DS) among pregnant women and their families is one of the interventions targeted to reduce maternal and newborn mortality. It is expected that knowledge in DS will lead to early care seeking once complications occur among women or newborns. Health care providers are required to educate women on DS of obstetric emergency during pregnancy, delivery and immediate-post-delivery. This study aimed to determine the level of knowledge on danger signs among rural women and its effect on antenatal care visits, birth preparedness and complication readiness (BPCR) and on use of skilled birth attendance (SBA) during childbirth.Methodology Community-based analytical cross-sectional study was conducted in July 2019 among women who delivered in the past 24 months in two wards at Babati Rural district, Tanzania. Questionnaire was used for data collection. Odds Ratio was used to assess association between knowledge on danger signs with use of services during pregnancy and childbirth.Results A total of 372 women were enrolled, with mean age of 28.5 years (S.D 7.2). All the women attended antenatal care at least once during pregnancy, 65.3% attended ANC 4 or more visits, 85.2% of women were assisted by SBA during childbirth, and 13.7% of the women had birth preparedness and complication readiness plan. Overall, 272 (73.1%) women reported that they were counseled about obstetric danger signs during antenatal clinic visits, but only 32% could mention three or more DS of obstetric and newborn emergency. Overall good knowledge of DS and knowledge of obstetric danger signs during pregnancy were significantly associated with 4 or more ANC visits and birth preparedness and complication readiness but not with SBA use during childbirth.Conclusion Majority of women were counseled on DS during pregnancy, however more than three quarters (68%) had low knowledge. Women who were knowledgeable on danger signs during pregnancy attended 4+ ANC visits and prepared for birth and its complications. There is a need of designing alternative models of engaging women during education/ counseling sessions so that they may have a higher retention of knowledge not only of danger signs but for other maternal and newborn health issues.

scholarly journals Birth Preparedness and Complication Readiness Among Women of Reproductive Age in Kenya and Tanzania: A Community-Based Cross-Sectional Survey

2020 ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Micheal A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Introduction: Delayed health seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay includes 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.Methods: We 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 (2016-17). 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.Results: Only 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).Conclusion: Overall, 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.

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Micheal A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Introduction: Delayed 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.Methods: We 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.Results: Only 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).Conclusion: Overall, 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.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

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