Husbands’ participation in birth preparedness and complication readiness plan in Kucha district, Gamo Zone, Southern Ethiopia

Background Birth-preparedness and complication-readiness (BPCR) is the process of planning for normal birth and anticipating the actions needed in case of an emergency. The involvement of husband during pregnancy helps a mother to make timely decisions to avoid delays. Identifying the level of husband involvement in Birth-preparedness and complication-readiness is very important, as husband is the major decision maker in household and health service related issue. However, there is no sufficient data in the Kucha district, which describes the level of husband involvement in Birth-preparedness and complication-readiness. Therefore, this study assessed the level of husband involvement in birth preparedness and complication readiness in Kucha District, Gamo Zone, Ethiopia. Methods Community-based cross-sectional study was conducted on 421 husbands whose wife gave birth within the last 12 months at Kucha District using simple random sampling technique. Data was collected using a pretested interviewer-administered questionnaire by trained data collectors. Binary and multivariable logistic regression with odds ratios along with the 95% confidence interval analysis were employed to find factors associated with the level of husband involvement. A p-value <0.05 with 95% confidence level used to decide statistical significance. Results Data were collected from 421 study participants. One hundred twenty-seven (30.2%) were involved in birth preparedness and complication readiness plan. Participants who had at least secondary school education AOR = 3.1, CI (1.84–5.23), had at least four antenatal care visits AOR = 4.91, CI (2.36–10.2), and live more than five km from the health care facility AOR = 2.35, CI = 1.40–3.96) were involved in birth preparedness and complication readiness plan. Conclusion Husbands’ involvement in birth preparedness and complication readiness was low. Husband’s higher educational level, high frequency of antenatal care, and long distance to the health facility were significantly associated with husbands’ involvement in Birth-preparedness and complication-readiness plan. Therefore, advocating for higher frequency of antenatal care and improving educational level are important to increase husbands’ involvement in birth preparedness and complication readiness plan.

Emergency caesarean section and its sequelae in a tertiary hospital in Niger Delta, Nigeria

Background: Caesarean section (CS) is one of the most common surgical procedure in obstetrics. It involves a surgical incision made through the abdominal and uterine walls to deliver the foetus and placenta after the period of foetal viability.Methods: This was a cross-sectional study aimed at reviewing emergency caesarean section in Rivers State University Teaching Hospital (RSUTH) over a 5-year period, to determine the prevalence and sequelae. Data were analysed using IBM Statistical Product and Service Solution (SPSS) version 25.0 (Armonk, NY).Results: During the review period, there were 13516 deliveries and 3699 cases of emergency CS, giving the prevalence of emergency CS as 27.4% or 274 per 1000 deliveries. Majority (90%) of the parturient were unbooked. The most common complication in women that had emergency caesarean section was fever (56.4%), followed by endometritis (14.7%), absconding from hospital (8.8%), urinary tract infection (7.1%) and wound infection (6.1%). There was a statistically significant association between types of CS and their sequelae, χ2=1153.9, p<0.001, (95% CI: 0.000, 0.000). Women that had emergency CS were 101 times more likely to have a complication compared to those that had planned CS.Conclusions: The rate of emergency caesarean section is high in RSUTH and with more complications compared to planned caesarean section. Booking for antenatal care, early presentation for delivery, birth preparedness and complication readiness will enhance improved maternal and perinatal outcome.

The dropout rate and associated factors of the continuum of maternal health care services before and during Covid-19 Pandemic among women who gave birth in the last two years in Addis Ababa, Ethiopia, 2021. A comparative cross-sectional study design

Background A continuum of maternal health care is the continuity of care during pregnancy, delivery, and post-delivery period. However, the dropout rate of the continuum care and factors associated with it during the COVID-19 pandemic were not well documented in the study setting. Hence, this study was used to assess the dropout rate and associated factors of the continuum of care before and during the COVID-19 pandemic. Methods A community-based comparative cross-sectional study was conducted among 630 women who gave birth in the last two years in Addis Ababa. An interviewer-administered questionnaires were used to collect the data. The Epi data version 4.6 and STATA version 14 statistical Softwares were used for data entry and analysis, respectively. Binary logistic regression model was used to identify associated factors of the dropout rate of a continuum of care. Result The dropout rate of the continuum of maternal healthcare was 58.39% (95% CI: 52.56-64.00) and 73.24% (95% CI: 67.91-77.98) before and during the covid-19 pandemic respectively. Women who had no information about PNC (AOR =1.88, 95% CI: 1.01-3.50), not received appropriate care (AOR = 3.92, 95% CI: 1.84-8.37), no information about maternal health care (AOR=2.57, 95% CI: 1.28-5.16), birth preparedness and complication readiness (AOR=0.47, 95% CI: 0.26-0.86), and had history of pregnancy-related complications (AOR=2.07, 95% CI: 1.17-3.68), were dropped out from continuum of care during the covid-19 pandemic. whereas, unplanned pregnancy (AOR= 3.35, 95% CI: 1.60-7.04), not know postpartum danger signs (AOR=1.79,95% CI: 1.03-3.12), and no information about maternal health care (AOR= 1.85, 95% CI: 1.06-3.23) were dropped out from continuum of care before covid-19 pandemic. Conclusion This study underscores nearly three fourth and more than half of women during and before the covid-19 pandemic dropped out from the continuum of care, respectively. Information about maternal health care, birth preparedness and complication readiness, information about PNC, and knowing postpartum danger signs were significantly associated with the dropout rate of the continuum of care. Thus, adapting policy that supports service delivery modification during such pandemic, promoting birth preparedness and complication readiness is very crucial.

BIRTH PREPAREDNESS AND COMPLICATION READINESS OF WOMEN IN NIGERIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Introduction Globally, efforts are being made to reduce the menace of maternal death in order to achieve the sustainable development goal. Maternal death has been associated with inadequate birth preparedness and complication readiness especially in the low and middle income countries. Therefore, this review assessed birth preparedness and complication readiness in Nigeria. Methods A systematic review and meta-analysis of published research articles on birth preparedness and complication readiness in Nigeria was done using PubMed, EMBASE and MEDLINE databases. All published articles from inception to November, 2018 were included in the review. A total of 8913 published articles were identified from electronic search, a total of 4440 studies were included in this review, while only 12 articles met the inclusion criteria and were included in the meta-analysis. Results The pooled prevalence of Good BPCR for all studies yielded an estimate of 58.7% (95% CI 43.9 to 72.7%). The I2 statistic was 98%, indicating statistically significant heterogeneity among the studies. The percentage of women with good birth preparedness and complication readiness increases with increasing year of publication, such that women tended to be more aware good birth preparedness and complication readiness in recent years. More than half of the women had knowledge of obstetric danger signs (52.0%, 95% CI 39.5 to 64.4%, 10 studies), arranged for transportation (59.5%, 95% CI 36.2 to 80.7, 11 studies) or saved money (63.4%, 95% CI 44.7 to 80.2%, 11 studies) as part of the BPCR. Conclusion Women in Nigeria are better prepared for birth preparedness and complication readiness in recent years. Therefore, interventions to promote more adequate birth preparedness and complication readiness among women is recommended.

Testing the effectiveness of Community-Based Continuous Training Project on Improving the Domains of Birth Preparedness and Complication Readiness Intention Among Expecting Couples in Rural Settings of Rukwa Tanzania, A Controlled Quasi Experimental Study

Background: According to theory of planned behavior, the intention to engage into a behavior predicts the behavior to occur. The intention to engage into a behavior is influenced by three domains which are the attitude towards the behavior, the perceived subjective norms and the perceived behavior control. The study aimed at testing the effectiveness of a Community Based Continuous training (CBCT) intervention on improving the three domains of Birth Preparedness and Complication Readiness (BPCR) intention. Method: The quasi-experimental study design with control was done from June 2017 until March 2018. A multi-stage sampling technique was used to obtain 561 couples. Pre-test and end-line information were collected using semi-structured questionnaires developed using theory of planned behavior. The effectiveness of the intervention on improving domains of BPCR intention was assessed by using both independent t-test and pared t-test. Results: In comparison between groups at posttest assessment, there was a significant increase in mean scores only on perceived subjective norms in the intervention group if compared to the control group among pregnant women. Among male partners, none of the domain showed a significant difference between the intervention group and control group. In the comparison within groups, mean scores in all three domains had significant increase at posttest in both groups among male partners while among pregnant women the significant increase in the three domains were only among pregnant women in the intervention group. The predictor of change on attitudes and subjective norms mean scores were only the intervention β=0.065, p<0.05 and β=0.112, p=0.001 respectively. Predictors of change in perceived behavior control mean scores towards birth preparedness were level of education (secondary school, β=0.066, p<0.05), age at marriage (more than 24 years, β=0.069, p<0.05) and ethnic group (others, β=-0.067, p<0.05).Conclusion: The improvement brought by the intervention indicates that the intervention has the potential to significantly change the attitude and subjective norms domains of BPCR intention. The study recommends the CBCT intervention to be used in rural community to improve attitude and perceived subjective norms of BPCR intention.

MEN KNOWLEDGE/AWARENESS LEVEL ON BIRTH PREPAREDNESS AND COMPLICATION READINESS IN MAGARINI SUB COUNTY

Purpose: This study sought to find out the knowledge/awareness level of men on birth preparedness and complication readiness in Magarini Sub County. Methodology: A cross-sectional study sequential mixed methods design was used where a total of 464 men will be enrolled. Quantitative data was collected using semi structured questionnaires and interview guides were used to collect qualitative data. Quantitative data was coded, and analyzed by SPSS software. Qualitative data was analyzed using NVIVO software. Chi- square test was used to determine associations between categorical variables and Logistics regression was used to identify factors associated with birth preparedness and complication readiness. The associations between awareness and each independent variable were determined by odds ratio (OR) and 95% confidence interval (CI). Thematic content analysis was applied for qualitative data analysis. Findings: The result indicated that the odds of pregnancies resulting in a baby that was born alive were 47.306 times higher for more than two pregnancies as compared to one pregnancy(Odds=47.306,p=0.000). The odds of pregnancies resulting in a baby that was born alive were 16.25 times higher for one pregnancies as compared to no pregnancy(Odds=16.25,p=0.000). Unique contribution to theory, practice and policy Birth Preparedness and Complication Readiness (BPACR) should be endorsed as an essential component of safe motherhood programs to reduce delays for care-seeking for obstetric emergencies and this has been proven to positively impact on birth outcomes Keywords: knowledge/awareness level, birth preparedness, complication readiness, Magarini Sub County

To Assess the Effectiveness of Self-Instructional Module on Knowledge Regarding Obstetric Danger Signs, Birth Preparedness and Complications Readiness among the Primigravida Mothers

Background: Every pregnant woman faces the possibility of unforeseeable pregnancy problems, which can result in morbidity or fatality for herself or her infant. As a result, the concept of birth preparedness and complication readiness was developed, in which the family and community should plan ahead of time to protect the safety and well-being of the women and their new-borns throughout pregnancy, delivery, and after delivery. In the event of pregnancy and delivery problems, delivery intrapartum, and after postpartum, good plans and preparations will enhance usage of professional care and reduce delays in receiving care. Good plans and preparations will increase the usage of expert care and reduce the time it takes to seek care in the case of pregnancy and delivery complications [1]. Objectives: 1. To assess the existing knowledge on obstetric danger signs, birth preparedness and complications readiness among primigravida mothers. 2. To evaluate the effectiveness of self- instructional module on knowledge regarding obstetric dangers signs, birth preparedness and complications readiness among the primigravida mothers. 3. To find out the association between the knowledge regarding obstetric danger signs, birth preparedness and complications readiness with selected demographic variables. Materials and Methods: It is a quantitative research approach, in which one group pre-test post-test design will be used. Purposive sampling technique will be used to collect the data. Self-instructional module and structured questionnaire will be used to assess the effectiveness of self-instructional module on knowledge regarding obstetric danger signs, birth preparedness and complication readiness among the primigravida mothers.

Knowledge, Attitude and Perception of Planning Regarding Birth Preparedness and Complication Readiness at Tertiary Care Hospital Lucknow

Background: Globally, eight hundred women die every day due to pregnancy or child birth related complications. Aim: A descriptive study to assess the level of birth preparedness and complication readiness among antenatal women at a tertiary care hospital. Method: A descriptive cross sectional study was undertaken by using purposive sampling technique to assess the knowledge, attitude and planning of perception among antenatal women. Total 82 samples of antenatal women in third trimester were selected through purposive sampling from Tertiary care Hospital, Lucknow. Non experimental quantitative approach in which structured interview questionnaire was used for assessing the socio demographic data. Knowledge by interview method, attitude by likert scale and perception of planning by contingency questionnaire. Descriptive and Inferential statistics were used for the analysis of the tabulated data. Results: Out of total study samples (n=82) 34(41%) of antenatal women were well prepared regarding BPCR whereas 47(57%) are average prepared and 1(1%) are less prepared regarding BPCR. Conclusion: Birth preparedness and complication readiness (BPCR) is a key component of globally accepted safe motherhood programs, which helps ensure women to reach professional care when labor begins and to reduce delays that occur when mothers in labor experience obstetric complications. Keywords: Assess, level, antenatal women, BPCR

Male partners’ participation in birth preparedness and complication readiness in low- and middle-income countries: a systematic review and meta-analysis

Background Maternal and neonatal health outcomes remain a challenge in low- and middle-income countries (LMICs) despite priority given to involving male partners in birth preparedness and complication readiness (BPCR). Men in LMICs often determine women’s access to and affordability of health services. This systematic review and meta-analysis determined the pooled magnitude of male partner’s participation in birth preparedness and complication readiness in LMICs. Methods Literature published in English language from 2004 to 2019 was retrieved from Google Scholar, PubMed, CINAHL, Scopus, and EMBASE databases. The Joanna Briggs Institute’s critical appraisal tool for prevalence and incidence studies were used. A pooled statistical meta-analysis was conducted using STATA Version 14.0. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis was carried out to validate publication bias and heterogeneity. The random effect model was used to estimate the summary prevalence and the corresponding 95% confidence interval (CI) of birth preparedness and complication readiness. The review protocol has been registered in PROSPERO number CRD42019140752. The PRISMA flow chart was used to show the number of articles identified, included, and excluded with justifications described. Results Thirty-seven studies with a total of 17, 148 participants were included. The pooled results showed that 42.4% of male partners participated in BPCR. Among the study participants, 54% reported having saved money for delivery, whereas 44% identified skilled birth attendants. 45.8% of male partners arranged transportation and 57.2% of study participants identified health facility as a place of birth. Only 16.1% of the male partners identified potential blood donors. Conclusions A low proportion of male partners were identified to have participated in BPCR in LMICs. This calls countries in low- and middle-income setting for action to review their health care policies, to remove the barriers and promote facilitators to male partner’s involvement in BPCR. Health systems in LMICs must design and innovate scalable strategies to improve male partner’s arrangements for a potential blood donor and transportation for complications that could arise during delivery or postpartum haemorrhage.