scholarly journals Proposed Framework for Making Focused Antenatal Care Services Accessible: A Review of the Nigerian Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
John Ekabua ◽  
Kufre Ekabua ◽  
Charles Njoku
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Traditional Approach ◽  
Maternal Mortality Ratio ◽  
Teaching Hospitals ◽  
Care Group ◽  
Birth Preparedness ◽  
Skilled Attendant ◽  
Complication Readiness ◽  
Focused Antenatal Care

The aim of this paper is to propose a framework for making antenatal care an effective strategy in reducing the high maternal mortality ratio in Nigeria. On-site visits to five teaching hospitals were carried out between 2006 and 2008 to assess the practice of antenatal care. Group discussions with 200 parturients on their awareness of birth preparedness/complication readiness were conducted, in October, 2008. The findings of this study are discussed in line with the proposed practice of focused antenatal care. The practice of antenatal care in all the hospitals visited was the traditional approach based on earlier European models. Awareness of birth preparedness/complication readiness, by parturients, as a goal-directed intervention during antenatal care was low (21.5%). To reduce maternal deaths through antenatal care, it is critical to link care with detecting and treating causes of maternal mortality by a skilled attendant.

scholarly journals Maternal and newborn healthcare practices: assessment of the uptake of lifesaving services in Hoima District, Uganda

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Geoffrey Babughirana ◽  
Sanne Gerards ◽  
Alex Mokori ◽  
Elisha Nangosha ◽  
Stef Kremers ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Newborn Care ◽  
Poor Quality ◽  
Birth Preparedness ◽  
Essential Newborn Care ◽  
Complication Readiness ◽  
Live Births ◽  
Danger Signs ◽  
Maternal And Newborn

Abstract Background The current maternal mortality ratio in Uganda is 336 maternal deaths per 100,000 live births. Infant mortality is 43 deaths per 1000 live births, with 42% of the mortality occurring during the neonatal period. This might be related to a weak health system in the country. This study aimed at assessing the uptake of lifesaving services during pregnancy and childbirth in Hoima District, Uganda. Methods The study used a cross-sectional quantitative design among 691 women with a child under 5 years. Households were randomly sampled from a list of all the villages in the district with the ENA for SMART software using the EPI methodology. Pre-coded questionnaires uploaded in the Open Data Kit were used for data collection. The data was cleaned and analysed using MS Excel and SPSS software. Descriptive results are presented. Results Of the 55.1% women attending at least four antenatal care (ANC) visits, only 24.3% had the first ANC within the first trimester. Moreover, ANC services generally was of poor quality, with only 0.4% meeting all the requirements for quality of ANC service. The highest contributors to this poor quality included poor uptake of iron-folic acid (adherence 28.8%), the six-required birth preparedness and complication readiness items (13.2%), and recognition of the seven danger signs of pregnancy (3.0%). Adherence to the seven essential newborn care actions was very low (0.5%), mainly caused by three practices: initiating breastfeeding within 1 h (59.9%), lack of postnatal care within 24 h (20.1%), and failure to recognize the 6 danger signs of the newborn (2.4%). Only 11.1% of the males participated in all maternal and newborn care requirements, by encouraging women to seek healthcare (39.9%), accompanying them to healthcare (36.9%), and HIV counselling and support services (26.2%). Conclusion The study reveals poor maternal and newborn practices throughout the continuum of care, from ANC and skilled birth attendance to newborn care during childbirth. With such poor results, it is not surprising that Hoima is sixth of 10 districts that have the highest numbers of deaths due to maternal mortality in Uganda.

scholarly journals Intended Pregnancy as a Predictor of Good Knowledge on Birth Preparedness and Complication Readiness: the Case of Northern Ethiopia Pregnant Mothers

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Haile Zewdu Tsegaw ◽  
Endeshaw Admassu Cherkos ◽  
Marta Berta Badi ◽  
Muhabaw Shumye Mihret
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Multivariable Analysis ◽  
Good Knowledge ◽  
P Value ◽  
Northern Ethiopia ◽  
Birth Preparedness ◽  
Multivariable Logistic Regression Model ◽  
Cross Sectional ◽  
Complication Readiness

Background. Maternal mortality remains unacceptably high in developing countries. One key strategy to reduce such mortality is utilization of birth preparedness and complication readiness (BP/CR) and creating awareness of BP/CR is an important step for pregnant women, their families, and the community. However, there was limited to no evidence regarding the community’s awareness on BP/CR in the study area. Therefore, this study aimed to assess knowledge on BP/CR and associated factors among pregnant women in Debremarkos town, Northwest Ethiopia, 2017. Methods. A Community based cross-sectional study was conducted from July 1 to 30/2017. A total of 441 pregnant women were included in the study. Structured and pretested questionnaire was administered through face to face interview to collect the data. Simple random sampling technique was used to select the study participants. The data were entered in to Epinfo version 7.0 and then exported to SPSS version 20.0 for analysis. Both bivariate and multivariable logistic regression model were fitted. Crude and adjusted odds ratio with 95 % confidence interval have been computed and variables with p-value < 0.05 were considered statistically significance. Results. The proportion of pregnant women having good knowledge on birth preparedness and complication readiness was found to be 45.2 with 95%CI (40.4, 50.0). In the multivariable analysis, having history of childbirth (AOR=2.17;95%CI:1.18,4.00), having intended pregnancy (AOR=2.13;95%CI: 1.16, 3.90), being governmental employee ( AOR=6.50; 95%CI: 2.50, 16.87), and having Antenatal care visits (AOR=5.50; 95%CI:2.2,13.70) were factors which were independently and significantly associated with good knowledge on birth preparedness and complication readiness. Conclusion. Proportion of pregnant women having good knowledge on birth preparedness and complication readiness was low. Putting emphasis on intended pregnancy and antenatal care visit was recommended.

scholarly journals Sub-regional disparities in the use of antenatal care service in Mauritania: findings from nationally representative demographic and health surveys (2011–2015)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gebretsadik Shibre ◽  
Betregiorgis Zegeye ◽  
Bright Opoku Ahinkorah ◽  
Dina Idriss-Wheeler ◽  
Mpho Keetile ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Statistical Significance ◽  
Maternal Mortality Ratio ◽  
Population Attributable Risk ◽  
Population Attributable Fraction ◽  
Regional Disparities ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Mortality Ratio

Abstract Background Skilled antenatal care (ANC) has been identified as a proven intervention to reducing maternal deaths. Despite improvements in maternal health outcomes globally, some countries are signaling increased disparities in ANC services among disadvantaged sub-groups. Mauritania is one of sub-Saharan countries in Africa with a high maternal mortality ratio. Little is known about the inequalities in the country’s antenatal care services. This study examined both the magnitude and change from 2011 to 2015 in socioeconomic and geographic-related disparities in the utilization of at least four antenatal care visits in Mauritania. Methods Using the World Health Organization’s Health Equity Assessment Toolkit (HEAT) software, data from the 2011 and 2015 Mauritania Multiple Indicator Cluster Surveys (MICS) were analyzed. The inequality analysis consisted of disaggregated rates of antenatal care utilization using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population attributable risk, Ratio and Population attributable fraction). A 95% Uncertainty Interval was constructed around point estimates to measure statistical significance. Results Substantial absolute and relative socioeconomic and geographic related disparities in attending four or more ANC visits (ANC4+ utilization) were observed favoring women who were richest/rich (PAR = 19.5, 95% UI; 16.53, 22.43), educated (PAF = 7.3 95% UI; 3.34, 11.26), urban residents (D = 19, 95% UI; 14.50, 23.51) and those living in regions such as Nouakchott (R = 2.1, 95% UI; 1.59, 2.56). While education-related disparities decreased, wealth-driven and regional disparities remained constant over the 4 years of the study period. Urban-rural inequalities were constant except with the PAR measure, which showed an increasing pattern. Conclusion A disproportionately lower ANC4+ utilization was observed among women who were poor, uneducated, living in rural areas and regions such as Guidimagha. As a result, policymakers need to design interventions that will enable disadvantaged subpopulations to benefit from ANC4+ utilization to meet the Sustainable Development Goal (SDG) of reducing the maternal mortality ratio (MMR) to 140/100, 000 live births by 2030.

scholarly journals Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant: A Systematic Review

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0143382 ◽  
Author(s):  
Andrea Solnes Miltenburg ◽  
Yadira Roggeveen ◽  
Laura Shields ◽  
Marianne van Elteren ◽  
Jos van Roosmalen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Birth Preparedness ◽  
Skilled Attendant ◽  
Complication Readiness

scholarly journals Birth Preparedness and Complication Readiness Practice and Associated factors among Women Attending Antenatal care Follow up in Yirgalem General Hospital, Sidama Zone, Southern Ethiopia, 2019

2020 ◽  
Author(s):  
Molalegn Mesele Gesese ◽  
Walellign Anmut Tirfe
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
General Hospital ◽  
Associated Factors ◽  
Southern Ethiopia ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Factors Associated ◽  
History Of

Abstract Background: Birth preparedness and complication readiness is an approach that inspires pregnant women, their families and individuals to successfully design strategy for childbirths and deal with emergencies. In developing countries, world health organization estimates that more than 300 million women suffer from short-term and long-term complications related to pregnancy and child birth. In Ethiopia only 32% women have birth preparedness. The aim of this study is to assess practice and Associated factors of birth preparedness and complication readiness among Women Yirgalem General Hospital, Sidama Zone, Southern Ethiopia, 2019Methods: Facility based cross-sectional study was conducted from September 1st to 30th, 2019. A total of 422 pregnant women were randomly selected and interviewed by using pretested structured questionnaire. Data was entered by Epi-data version 3.1 and the analysis was done by SPSS version 21. Bivariate and multivariable logistic regression was performed to identify factors associated with birth preparedness and complication readiness.Result: From 422 study participants, 356(48.6%) (95% CI: 46.9%, 49.8%) have birth preparedness and complication readiness practice. Age of respondent ≥ 37 years (AOR =4.2, 95% C.I =1.23, 14.24) and between 25 to 30 (AOR=2.35, 95% C.I =1.1, 5.1); level of education College and above(AOR=5.59, 95% C.I 2.8, 11.2)and secondary school (AOR=9.5, 95% C.I 3.99-22); previous history of ANC follow up (AOR=4.33, 95% C.I = 2.46, 7.61) and history of birth at health facility (AOR=3.09, 95% C.I= 1.72, 5.56) where factors associated with birth preparedness and complication readiness practice. Conclusion: Relatively higher birth preparedness and complication readiness practice was observed in this study when compared with previous studies. Health extension workers and health care provider should encouraged women to actively utilize the health services and the governments with other stakeholders should works on antenatal care and institutional delivery by focusing on women those has no formal education.

scholarly journals MATERNAL MORTALITY

2009 ◽  
Vol 16 (03) ◽  
pp. 445-553
Author(s):  
SADIA KHAN ◽  
ASMA TANVEER USMANI ◽  
NAILA IFTIKHAR
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Economic Status ◽  
Maternal Mortality Ratio ◽  
Maternal Deaths ◽  
Developed Country ◽  
Mortality Ratio ◽  
Underlying Causes ◽  
One Year ◽  
A Prospective Study

Objective: The women residing in a developing country have 200 times greater risk of suffering from pregnancy and childbirthrelated mortality compared with the women of a developed country. To investigate relevant causes and the determinants of maternal mortalitythrough conducting scientific clinical studies. Methodologies: We conducted a prospective study of maternal deaths in the obstetrics andgynaecology unit of RGH for one year. Period: January 2007 to December 2007. We investigated the socio-demographic variables - includingage, parity, socio-economic status and literacy - along with the social behavior towards the antenatal. We designed standardized data collectingforms to collect data from the confidential hospital notes of the patients. The collected medical data of the patients proved useful in analyzingthe underlying causes and the risk factors behind direct and indirect maternal mortalities. Results: In our unit, we have recorded 28 maternaldeaths during the study period. 24 (86%) deaths are due to the direct causes and 4 (14%) are due to the indirect causes. The leading directcauses are hemorrhage 9 (37.5%), eclampsia 7 (29%), septicemia 5 (21%) and anaesthesia complications 2 (8%). Similarly, the distributionof indirect causes is: blood transfusion reactions 2 (50 %), hepatic failure 2 (50 %), Consequently, crude maternal mortality rate can beextrapolated at 645 per 100,000 maternities and maternal mortality ratio at 659 per 100,000 live births. The socio demographics of the deadmothers are: 16 (57%) patients in the age group of 25-35 years, 13 (52%) are multiparas (G2-G4) and 10 (36%) are grandmulti para i.e. G5and above. Moreover, 13 (46%) of them expired at term. The majority of them is illiterate and belongs to lower socio-economic group. 14 (42%)mothers have not received antenatal care and just 4 (15%) of them have received antenatal care from RGH or other hospital. 23 (92%) patientshave been suffering from anemia and we received 15 (54%) of them in a critical state with the hospital stay of less than 12 hours. C o n c l u s i o n :In our study hemorrhage and hypertensive disorders of pregnancy are the leading causes of maternal deaths. We argue that most of thesematernal deaths could have been possibly avoided by periodic interventions during the pregnancy, child birth and the postpartum period.

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.

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