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

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.

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Men’s knowledge and involvement on obstetric danger signs, birth preparedness and complication readiness in Burayu town, Oromia region, Ethiopia

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2661-4 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Addisu Gize ◽

Alemtsehay Eyassu ◽

Balkachew Nigatu ◽

Mekonen Eshete ◽

Nebiyou Wendwessen

Keyword(s):

Study Participant ◽

Urban Setting ◽

Birth Preparedness ◽

Danger Sign ◽

Cross Sectional ◽

Complication Readiness ◽

Obstetric Danger Signs ◽

Danger Signs ◽

Men’S Knowledge ◽

Men’S Involvement

Abstract Background Men’s involvement in obstetrics care is an important strategy in reducing preventable maternal morbidity and mortality. This is particularly important in developing countries where men often make decision on financial, health and other family issues. Hence, the objective of this study was to assess men’s knowledge and involvement in obstetric danger signs; birth preparedness and complication readiness in Burayu town administration, Oromia, Ethiopia. Methods A community based cross-sectional study was conducted in Burayu town administration, Oromia Region from May 2016 to July 2016. Multistage with systematic random sampling techniques were employed. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20. P-value less than 0.05 were taken as a cutoff point to declare significant association. Result A total of 523 men were involved in the study. The mean and ± SD age of the study participant was 36.6 ± 7 years. Majority of the participants were Orthodox religion followers and, employees of private organization, regarding residency majority were residing in urban setting. Pregnancy related vaginal bleeding was the most familiar danger sign recognized by the study participants which was 342(65.4%). From the total, 441(84.3%) of men were highly involved in preparation of arranging for postpartum cultural food expenses, 345(66.0%) for clean clothes both for the baby and mother; and 71–76% participants were involved in availing transport money for antenatal, delivery and postnatal care. The study revealed that educational status of men, monthly income, knowledge of pregnancy danger sign, delivery and post-delivery care, and knowledge of birth preparedness and complication readiness (BP/CR) were significantly associated with men’s involvement in BP/CR. Conclusion Majority of participants had knowledge on obstetric danger sign. Men showed low interest to donate blood to their wives during antenatal, delivery and postpartum care. There is a need continued awareness creation on danger sings as well as birth preparedness.

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

Tribhuvan University Journal ◽

10.3126/tuj.v33i1.28682 ◽

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.

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

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03297-w ◽

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.

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Prevalence and predictors of birth preparedness and complication readiness in the Kassena-Nankana district of Ghana: an analytical cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-042906 ◽

2021 ◽

Vol 11 (3) ◽

pp. e042906

Author(s):

Mahama Saaka ◽

Lawal Alhassan

Keyword(s):

Wealth Index ◽

Household Wealth ◽

Cross Sectional Study ◽

Primary Outcome Measure ◽

Birth Preparedness ◽

Cross Sectional ◽

Complication Readiness ◽

Obstetric Danger Signs ◽

Danger Signs ◽

High Educational

ObjectivesTo assess birth preparedness and complication readiness (BPACR) and associated factors among mothers who had given birth in the past 12 months prior to the study.DesignAn analytical cross-sectional study.SettingThe study was carried out in the rural areas of Kassena-Nankana district located in the Upper East Region of Ghana.ParticipantsThe study population comprised 600 postpartum women who had delivered within the last 12 months prior to the study.Primary outcome measureThe primary outcome measure was BPACR.ResultsThe prevalence of BPACR among recently delivered women was very low as less than 15% were able to mention at least three of the five basic components of birth preparedness/complication readiness that were fulfilled. After adjustment for confounding effect using multivariable logistic regression analysis, high educational level (adjusted OR (AOR)=3.40 (95% CI: 1.88 to 6.15)), better knowledge about obstetric danger signs during pregnancy (AOR=4.88 (95% CI: 2.68 to 8.90)), older women (≥35 years) (AOR=2.59 (95% CI: 1.11 to 6.02)), women of low household wealth index (AOR=4.64 (95% CI: 1.97 to 10.91)) and women who received lower content of antenatal care services (AOR=3.34 (95% CI: 1.69 to 6.60)) were significant predictors of BPACR.ConclusionThis study concludes that BPACR practices were low. High educational attainment of the woman, having adequate knowledge about obstetric danger signs during pregnancy, older women (≥35 years) and women of low household wealth index were significant predictors of BPACR. The predictors identified should be given high priority by health authorities in addressing low prevalence of BPACR.

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

10.21203/rs.2.16594/v1 ◽

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.

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

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/4317 ◽

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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Knowledge and intake of folic acid to prevent neural tube defects among pregnant women in urban China: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03893-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mingming Cui ◽

Xiao-Lin Lu ◽

Yan-Yu Lyu ◽

Fang Wang ◽

Xiao-Lu Xie ◽

...

Keyword(s):

Folic Acid ◽

Pregnant Women ◽

Neural Tube ◽

Neural Tube Defects ◽

Rural Women ◽

Rural Areas ◽

Urban Areas ◽

Unplanned Pregnancy ◽

Urban China ◽

Cross Sectional

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.

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Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03580-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saran Tenzin Tamang ◽

Thinley Dorji ◽

Sonam Yoezer ◽

Thinley Phuntsho ◽

Phurb Dorji

Keyword(s):

Pregnant Women ◽

Knowledge Score ◽

Antenatal Clinic ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Obstetric Danger Signs ◽

Danger Signs ◽

Obstetric Emergencies ◽

Level Of Knowledge

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

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Men’s Knowledge of Obstetric Danger Signs, Birth Preparedness and Complication Readiness in Rural Tanzania

PLoS ONE ◽

10.1371/journal.pone.0125978 ◽

2015 ◽

Vol 10 (5) ◽

pp. e0125978 ◽

Cited By ~ 27

Author(s):

Furaha August ◽

Andrea B. Pembe ◽

Rose Mpembeni ◽

Pia Axemo ◽

Elisabeth Darj

Keyword(s):

Birth Preparedness ◽

Complication Readiness ◽

Obstetric Danger Signs ◽

Danger Signs ◽

Rural Tanzania ◽

Men’S Knowledge

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Determinant of Practice of Birth Preparedness and Complication Readiness Plan Among Pregnant Women at Debretabor, North west Ethiopia: A Community Based Cross Sectional Study.

10.21203/rs.3.rs-49455/v1 ◽

2020 ◽

Author(s):

Berhan Tsegaye Negash

Keyword(s):

Pregnant Women ◽

Sampling Technique ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Birth Preparedness ◽

Cross Sectional ◽

Complication Readiness ◽

Preparedness Plan ◽

Education Status ◽

Partner Involvement

Abstract Background: Nearly all of maternal deaths in the world occurred in sub-Saharan African countries. As Ethiopian demographic health survey report, there were 412 maternal deaths per 100,000 live births in 2016. Delays in decision to seek and receive care are the main causes of these deaths. Birth preparedness and complication readiness plan has been globally endorsed pivotal strategy to decrease these delays. Therefore, this study was aimed to assess the level of practice and factors associated with practice of birth preparedness plan among pregnant women. Methods: Community based cross-sectional study was done among 356 pregnant women selected by simple random sampling technique from July 1-30/2017 in Debretabor town. We selected samples by simple random sampling technique. Data were collected using interview administered questionnaire. Then, we coded, cleaned and entered data through Epidata version 3.1. Finally, exported and analyzed by SPSS. Logistic regression analysis was done to identify association between explanatory variables and practice of birth preparedness and complication plan. An adjusted odds ratio with 95% confidence interval and p-value less than 0.05 was computed to determine the level of significance in multi-variable logistic regression model.Results: Prevalence of birth preparedness and complication readiness plan was 73.9% in this study. primary education status (AOR=3.2,95%CI,1.3-7.8) and secondary educational status (AOR=4.1,95%CI,1.6-10.3), Primigravida (AOR=4.7,95%CI,1.9-11.3), partner involvement in birth preparedness and complication readiness plan (AOR=3.4,95%CI,1.9-6.1), initiating antenatal care in first trimester and media exposure (AOR=1.9,95%CI,1.0-3.3) were significantly associated factors with birth preparedness and complication readiness plan in this study. Conclusions: Level of practice of birth preparedness and complication readiness plan was high in the current study. Higher education status, early ante-natal care initiation, partner involvement in birth preparedness and exposure to media were the factors associated with practice of birth preparedness and complication readiness. Therefore, emphasize on continues education through media, design educational curriculum which should include birth preparedness plan, increase partner participation in birth preparedness and complication readiness plan. Furthermore, early initiation of antenatal care is mandatory.

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