1
|
Yaya Tessema G, Ayele G, Fikadu Tessema K, Gendisha Ukke G, Godana Boynito W. Knowledge of postpartum complications and associated factors among women who gave birth in the last 12 months in Arba Minch Town, Southern Ethiopia, 2019: A community-based cross-sectional study. PLoS One 2023; 18:e0281242. [PMID: 36745601 PMCID: PMC9901784 DOI: 10.1371/journal.pone.0281242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/18/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The knowledge of women about obstetric complications can helps them to seek health care earlier before obstetric complications arise. Most maternal deaths occur due to the poor health care seeking behavior after childbirth, but little is done on maternal knowledge of postpartum complications. Therefore this study aimed to assess knowledge of postpartum complications and associated factors among women who gave birth in the last 12 months in Arba Minch Town, Sothern Ethiopia. METHODS A community-based cross-sectional study was conducted on 418 women from December 01 to 15, 2019. A multi-stage sampling method was applied to reach study units. A semi-structured questionnaire was used to collect the data using face-to-face interviews. Bivariable and multivariable logistic regression was applied to examine the relationship between dependent and independent variables. Statistical significance was declared at a P-value ≤ 0.05 with the corresponding 95% confidence level. RESULTS Knowledge of women on postpartum complications was 23.9%. Secondary and above educational level (AOR = 3.82, 95% CI: [1.70, 8.65]), Grand multiparity (AOR = 2.31, 95% CI: [1.13, 4.71]), having four and above ANC visit (AOR = 2.04, 95% CI: [1.10, 3.81]) and self-decision making power to seek care (AOR = 3.68, 95% CI: [2.21, 6.11]) were statistically significant factors. CONCLUSION AND RECOMMENDATION Mothers' knowledge of postpartum complications was low in this study area. Improving women's educational level, decision-making power to seek health care, and counseling during ANC follow-up may be useful approaches to increase their knowledge of postpartum complications.
Collapse
Affiliation(s)
- Godana Yaya Tessema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail: ,
| | - Gistane Ayele
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kassahun Fikadu Tessema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gebresilasea Gendisha Ukke
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Wanzahun Godana Boynito
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
2
|
Toolan M, Barnard K, Lynch M, Maharjan N, Thapa M, Rai N, Lavender T, Larkin M, Caldwell DM, Burden C, Manandhar DS, Merriel A. A systematic review and narrative synthesis of antenatal interventions to improve maternal and neonatal health in Nepal. AJOG GLOBAL REPORTS 2022; 2:100019. [PMID: 35252905 PMCID: PMC8883503 DOI: 10.1016/j.xagr.2021.100019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
3
|
Oguntunde O, Nyenwa J, Yusuf F, Sulaiman Dauda D, Salihu A, Sinai I. Factors associated with the knowledge of obstetric danger signs, and perceptions of the need for obstetric care amongst married young women in northern Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e9. [PMID: 33881335 PMCID: PMC8063520 DOI: 10.4102/phcfm.v13i1.2557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Married adolescents contribute to poor maternal health indicators in many low-and middle-income countries, where restrictive social norms hinder access to, and utilisation of maternal health services. Addressing these barriers is key to improving health outcomes of young mothers and their children. AIM This study assessed married young women's knowledge of obstetric danger signs and perceptions of the need to attend obstetric services. METHODS A cross sectional descriptive design, interviewing 1624 randomly selected married young women aged 12-25 years. Data were collected in early 2017 using an interviewer-administered questionnaire on mobile phones, and exported into a statistical software for analysis. RESULTS We found low levels of knowledge of danger signs, especially those pertaining to the post-partum period. Respondents' age, literacy and household wealth were significantly associated with knowledge of danger signs across the continuum of care. Awareness of danger signs during delivery, was strongly associated with perceptions of need for antenatal care (odds ratio[OR]= 2.269; p 0.05), and delivery in a health facility (OR = 1.883; P 0.05). Most respondents believed they must wait for their husband's approval to attend a health facility when in labour. CONCLUSION Our findings show that the low levels of knowledge of obstetric danger signs, low perceptions of the importance of facility delivery, and the need to obtain husband's permission before seeking care, are highly contextualised and reflect the socio-cultural and economic circumstances of married young women in northern Nigeria. Interventions must consider these cultural context, and include a strong male-involvement component.
Collapse
|
4
|
Tesfaye G, Chojenta C, Smith R, Loxton D. Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia. Reprod Health 2019; 16:167. [PMID: 31729986 PMCID: PMC6858740 DOI: 10.1186/s12978-019-0829-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Skilled delivery care utilization in Ethiopia is still very low compared with the goal set by the global community for countries with the highest maternal mortality. As a result, the country is overburdened with high maternal morbidity and mortality. We aimed to explore the predisposing, enabling, and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia. Methods A community-based cross-sectional study was conducted with a total of 1294 women. The participants were selected using systematic sampling techniques. An interviewer-administered structured questionnaire aided by an electronic survey tool was used to collect data. Univariate analyses were conducted to describe the study sample. Bivariate and multivariate logistic regression analyses were carried out to elicit the association of predisposing, enabling, and need factors associated with skilled delivery care utilization. Separate multivariate models were fitted for primiparous and multiparous women categories. Odds ratios with 95% confidence intervals were used to assess statistical significance. Results More than a quarter (30.8%) of the women surveyed used skilled delivery care for their most recent birth. Significant predisposing factors were as follows: presence of educated family member; receiving education on maternal health; previous use of skilled delivery care; and best friend’s use of maternal care. Place of residence was the enabling factor that predicted skilled delivery care use. Antenatal care attendance and pregnancy intention were significant need factors associated with skilled delivery care utilization. Conclusion The findings of the study highlight the need for a concerted effort to establish community-based peer education programs; improve access to family planning services (to reduce unintended pregnancies); increase antenatal care uptake; and facilitate access to skilled delivery care in rural areas.
Collapse
Affiliation(s)
- Gezahegn Tesfaye
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O Box: 235, Harar, Ethiopia. .,Research Centre for Generational Health and Ageing, Faculty of Health and Medicine University of Newcastle, Newcastle upon Tyne, NSW, Australia.
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine University of Newcastle, Newcastle upon Tyne, NSW, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine University of Newcastle, Newcastle upon Tyne, NSW, Australia
| |
Collapse
|
5
|
Woldeamanuel GG, Lemma G, Zegeye B. Knowledge of obstetric danger signs and its associated factors among pregnant women in Angolela Tera District, Northern Ethiopia. BMC Res Notes 2019; 12:606. [PMID: 31547838 PMCID: PMC6755683 DOI: 10.1186/s13104-019-4639-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 09/11/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Knowledge of danger signs of obstetric complications is the first essential step in accepting appropriate and timely referral to maternal and newborn care units. The objective of this study was to assess the knowledge of obstetric danger signs and associated factors among pregnant women in Angolela Tera district, Northern Ethiopia. A community based cross sectional study was conducted among 563 pregnant women who were selected by multi-stage cluster sampling technique. Data were collected using a pre-tested and interviewer administered structured questionnaire. Descriptive statistics and binary logistic regression analysis were performed using statistical package for social sciences (SPSS) version 23. RESULTS A total of 563 pregnant women were included in the study. About 211 (37.5%) women were knowledgeable about obstetric danger signs. Attending formal education, urban residence, time taken less than 20 min to reach health facility on foot, two or more history of pregnancies and receiving health education were found to be significantly associated with being knowledgeable about obstetric danger signs. A significant proportion of pregnant women in the study area were not knowledgeable about obstetric danger signs. Hence, continuous health education and appropriate counseling to pregnant mothers should be performed.
Collapse
Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, P.O. Box 07, Wolkite, Ethiopia.
| | - Gorems Lemma
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Betregiorgis Zegeye
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| |
Collapse
|
6
|
Vallely LM, Emori R, Gouda H, Phuanukoonnon S, Homer C, Vallely AJ. Women's knowledge of maternal danger signs during pregnancy: Findings from a cross-sectional survey in Papua New Guinea. Midwifery 2019; 72:7-13. [PMID: 30739884 DOI: 10.1016/j.midw.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/29/2019] [Accepted: 02/03/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To explore knowledge of pregnancy related danger signs among women attending antenatal clinics in Papua New Guinea. DESIGN Cross-sectional survey undertaken as part of a wider integrated health and demographic survey. SETTING Three sites in Papua New Guinea: Hiri District (Central Province), Karkar (Madang Province) and Asaro (Eastern Highlands Province). PARTICIPANTS 482 women aged 15-44 years. FINDINGS Almost all (95.2%; 459/482) women attended for antenatal care at least once; 68.2% attended four or more times. Among women who attended the antenatal clinic, 53.6% (246/459) reported receiving information about danger signs in pregnancy from a health worker. Of these 60.2% (148/246) could recall at least one danger sign. In addition, 16.4% (35/213) of women who did not receive information from the antenatal clinic reported pregnancy related danger signs. Among the 183 women who reported danger signs, 47.5% (87/183) reported fever; 39.3% (72/183) reported vaginal bleeding and 36.6% (67/183) reported swelling of the face, legs and arms. Women who reported receiving information at the antenatal clinic were significantly more likely know any danger signs, compared with women who did not receive information at the antenatal clinic (OR 7.68 (95%CI: 4.93, 11.96); p = <0.001). Knowledge of danger signs was significantly associated with secondary school education, compared with none or only primary education (OR 3.08 (95% CI: 2.06, 4.61); p = <0.001). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Every antenatal clinic visit should be used opportunistically to provide women with information about key danger signs during pregnancy and childbirth. Recognising maternal danger signs, together with the importance of seeking early transfer to the health facility and the importance of attending for a health facility birth are critical to improving outcomes for mothers and babies especially in low income settings such as Papua New Guinea.
Collapse
Affiliation(s)
- L M Vallely
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney 2052, Australia; Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
| | - R Emori
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
| | - H Gouda
- School of Public Health, University of Queensland, Brisbane, Australia.
| | - S Phuanukoonnon
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Cse Homer
- Burnet Institute, Melbourne, Victoria, Australia; Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology, Sydney, Australia.
| | - A J Vallely
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea; Kirby Institute, University of New South Wales, Sydney, Australia.
| |
Collapse
|
7
|
Muhumuza Kananura R, Tetui M, Bua J, Ekirapa-Kiracho E, Mutebi A, Namazzi G, Namusoke Kiwanuka S, Waiswa P. Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda: a quasi-experiment study. Glob Health Action 2018; 10:1362826. [PMID: 28849729 PMCID: PMC5645681 DOI: 10.1080/16549716.2017.1362826] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Knowledge of obstetric danger signs and adequate birth preparedness (BP) are critical for improving maternal services utilization. Objectives: This study assessed the effect of a participatory multi-sectoral maternal and newborn intervention on BP and knowledge of obstetric danger signs among women in Eastern Uganda. Methods: The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study was implemented in three districts from 2013 to 2015 using a quasi-experimental pre–post comparison design. Data were collected from women who delivered in the last 12 months. Difference-in-differences (DiD) and generalized linear modelling analysis were used to assess the effect of the intervention on BP practices and knowledge of obstetric danger signs. Results: The overall BP practices increased after the intervention (DiD = 5, p < 0.05). The increase was significant in both intervention and comparison areas (7–39% vs. 7–36%, respectively), with a slightly higher increase in the intervention area. Individual savings, group savings, and identification of a transporter increased in both intervention and comparison area (7–69% vs. 10–64%, 0–11% vs. 0–5%, and 9–14% vs. 9–13%, respectively). The intervention significantly increased the knowledge of at least three obstetric danger signs (DiD = 31%) and knowledge of at least two newborn danger signs (DiD = 21%). Having knowledge of at least three BP components and attending community dialogue meetings increased the odds of BP practices and obstetric danger signs’ knowledge, respectively. Village health teams’ home visits, intervention area residence, and being in the 25+ age group increased the odds of both BP practices and obstetric danger signs’ knowledge. Conclusions: The intervention resulted in a modest increase in BP practices and knowledge of obstetric danger signs. Multiple strategies targeting women, in particular the adolescent group, are needed to promote behavior change for improved BP and knowledge of obstetric danger signs.
Collapse
Affiliation(s)
- Rornald Muhumuza Kananura
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda.,c Makerere University Centre of Excellence for Maternal and Newborn Health Research , Kampala , Uganda
| | - Moses Tetui
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda.,b Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine Umeå University , Umeå , Sweden
| | - John Bua
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda
| | - Elizabeth Ekirapa-Kiracho
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda
| | - Aloysius Mutebi
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda
| | - Gertrude Namazzi
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda.,c Makerere University Centre of Excellence for Maternal and Newborn Health Research , Kampala , Uganda
| | - Suzanne Namusoke Kiwanuka
- b Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine Umeå University , Umeå , Sweden
| | - Peter Waiswa
- a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda.,c Makerere University Centre of Excellence for Maternal and Newborn Health Research , Kampala , Uganda.,d Global Health Division, Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
8
|
Salem A, Lacour O, Scaringella S, Herinianasolo J, Benski AC, Stancanelli G, Vassilakos P, Petignat P, Schmidt NC. Cross-sectional survey of knowledge of obstetric danger signs among women in rural Madagascar. BMC Pregnancy Childbirth 2018; 18:46. [PMID: 29402226 PMCID: PMC5800042 DOI: 10.1186/s12884-018-1664-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 01/09/2018] [Indexed: 12/03/2022] Open
Abstract
Background Antenatal care (ANC) has the potential to identify and manage obstetric complications, educate women about risks during pregnancy and promote skilled birth attendance during childbirth. The aim of this study was to assess women’s knowledge of obstetric danger signs and factors associated with this knowledge in Ambanja, Madagascar. It also sought to evaluate whether the participation in a mobile health (mHealth) project that aimed to provide comprehensive ANC to pregnant women in remote areas influenced women’s knowledge of obstetric danger signs. Methods From April to October 2015, a non-random, convenience sample of 372 women in their first year postpartum were recruited, including 161 who had participated in the mHealth project. Data were analyzed using bivariate and multivariate logistic regression. Results Knowledge of at least one danger sign varied from 80.9% of women knowing danger sign(s) in pregnancy, to 51.9%, 50.8% and 53.2% at delivery, postpartum and in the newborn, respectively. Participation in the mHealth intervention, higher household income, and receipt of information about danger signs during pregnancy were associated with knowledge of danger signs during delivery, in bivariate analysis; only higher household income and mHealth project participation were independently associated. Higher educational attainment and receipt of information about danger signs in antenatal care were associated with significantly higher odds of knowing danger sign(s) for the newborn in both bivariate and multivariate analysis. Conclusions Knowledge of obstetric danger signs is low. Information provision during pregnancy and with mHealth is promising. Trial registration This trial was retrospectively registered at the International Standard Randomized Controlled Trial Register (identifier ISRCTN15798183; August 22, 2015). Electronic supplementary material The online version of this article (10.1186/s12884-018-1664-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ania Salem
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Oriane Lacour
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | | | - Anne Caroline Benski
- Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland.,Centre Médico-chirurgical Saint Damien, Ambanja, Madagascar
| | | | - Pierre Vassilakos
- Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland
| | - Patrick Petignat
- Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland
| | - Nicole Christine Schmidt
- Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland.
| |
Collapse
|
9
|
Bililign N, Mulatu T. Knowledge of obstetric danger signs and associated factors among reproductive age women in Raya Kobo district of Ethiopia: A community based cross-sectional study. BMC Pregnancy Childbirth 2017; 17:70. [PMID: 28222694 PMCID: PMC5320700 DOI: 10.1186/s12884-017-1253-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/15/2017] [Indexed: 12/07/2023] Open
Abstract
Background Knowledge of danger signs of obstetric complications during pregnancy, labour, and postnatal period is the first essential step for appropriate and timely referral. This study aimed to investigate predictors of knowledge about obstetric danger signs during pregnancy, delivery, and postpartum period among mothers of reproductive age women who gave birth in the last 12 months. Methods A quantitative community based cross-sectional study was employed during March 2016. The study included 493 mothers who were selected by multi-stage sampling technique. Data were collected by face-to-face interview. Logistic regression analyses were employed to identify factors associated with knowledge of obstetric danger signs. Variables with a p-value <0.05 were identified as statistically significant factors. Results About forty-seven percent (46.7%), 27.8%, and 26.4% of the mothers were knowledgeable about obstetric danger signs during pregnancy, delivery, and postpartum period, respectively. Vaginal bleeding was the most frequently cited danger sign during the three periods. Mothers’ secondary or above education level increased odds of knowledge about danger signs during pregnancy (AOR: 3.63; 95% CI 1.19, 11.07) and postpartum period (AOR: 5.31; 95% CI 2.13, 13.22). Additionally, being employed (AOR: 5.41; 95% CI 1.03, 28.32), delivery at health institution (AOR: 2.14; 95% CI 1.17, 3.92) and number of ANC visits were statistically significant factors. Conclusion Knowledge of mothers about obstetric danger signs was low in the study area. Empowering women, improving the quality of health information about danger signs during ANC follow up, and promoting institutional delivery are the recommended interventions.
Collapse
Affiliation(s)
- Nigus Bililign
- Department of Midwifery, Faculty of Health sciences, Woldia University, PO.box: 400, Woldia, Ethiopia.
| | - Tesfahun Mulatu
- Department of Public Health, Faculty of Health sciences, Woldia University, Woldia, Ethiopia
| |
Collapse
|
10
|
Biswas A, Dalal K, Abdullah ASM, Gifford M, Halim MA. Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study. F1000Res 2016; 5:2417. [PMID: 27853517 PMCID: PMC5089125 DOI: 10.12688/f1000research.9445.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 01/15/2023] Open
Abstract
Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community. Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed. Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications. There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment. Conclusions: The rural community lacks adequate knowledge on maternal complications. Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.
Collapse
Affiliation(s)
- Animesh Biswas
- School of Health Sciences, Örebro University, Örebro, Sweden; Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Örebro University, Örebro, Sweden
| | | | - Mervyn Gifford
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - M A Halim
- Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh
| |
Collapse
|
11
|
August F, Pembe AB, Mpembeni R, Axemo P, Darj E. Effectiveness of the Home Based Life Saving Skills training by community health workers on knowledge of danger signs, birth preparedness, complication readiness and facility delivery, among women in Rural Tanzania. BMC Pregnancy Childbirth 2016; 16:129. [PMID: 27251052 PMCID: PMC4890507 DOI: 10.1186/s12884-016-0916-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 05/25/2016] [Indexed: 11/28/2022] Open
Abstract
Background In spite of government efforts, maternal mortality in Tanzania is currently at more than 400 per 100,000 live births. Community-based interventions that encourage safe motherhood and improved health-seeking behaviour through acquiring knowledge on the danger signs and improving birth preparedness, and, ultimately, reduce maternal mortality, have been initiated in different parts of low-income countries. Our aim was to evaluate if the Home Based Life Saving Skills education by community health workers would improve knowledge of danger signs, birth preparedness and complication readiness and facility-based deliveries in a rural community in Tanzania. Methods A quasi-experimental study design was used to evaluate the effectiveness of Home Based Life Saving Skills education to pregnant women and their families through a community intervention. An intervention district received training with routine care. A comparison district continued to receive routine antenatal care. A structured household questionnaire was used in order to gather information from women who had delivered a child within the last two years before the intervention. This questionnaire was used in both the intervention and comparison districts before and after the intervention. The net intervention effect was estimated using the difference between the differences in the intervention and control districts at baseline and endline. Results A total of 1,584 and 1,486 women were interviewed at pre-intervention and post intervention, respectively. We observed significant improvement of knowledge of three or more danger signs during pregnancy (15.2 % vs. 48.1 %) with a net intervention effect of 29.0 % (95 % CI: 12.8–36.2; p < .0001) compared to the comparison district. There was significant effect on the knowledge of three or more danger signs during childbirth (15.3 % vs. 43.1 %) with a net intervention effect of 18.3 % (95 % CI: 11.4–25.2; p < .0001) and postpartum for those mentioning three or more of the signs (8.8 % vs. 19.8 %) with net effect of 9.4 % (95 % CI: 6.4–15.7; p < .0001). Birth preparedness practice improved for those who made more than three actions (20.8 vs. 35.3 %) with a net intervention effect of 10.3 % (95 % CI: 10.3–20.3; p < .0001) between the intervention and control district at pre-intervention and post intervention. Utilisation of antenatal care with four visits improved significantly (43.4 vs. 67.8 %) with net effect of 25.3 % (95 % CI: 16.9–33.2; p < .0001), use of facility delivery improved in the intervention area (75.6 vs. 90.2 %; p = 0.0002) but there was no significant net effect 11.5 % (95 % CI: -5.1–39.6; p = 0.123) compared to comparison district. Conclusion This study shows that a community-based intervention employing community health workers as teachers in delivering Home Based Life Saving Skills program to pregnant women and their families improved their knowledge of danger signs during pregnancy, childbirth and postpartum, preparedness for childbirth and increased deliveries at health facilities which employ skilled health workers in this rural community. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0916-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Furaha August
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. .,Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden.
| | - Andrea B Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Rose Mpembeni
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Pia Axemo
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Elisabeth Darj
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden.,Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|