Knowledge about obstetric danger signs and associated factors among mothers in Tsegedie district, Tigray region, Ethiopia 2013: community based cross-sectional study

Sex Disparities: Couple's Knowledge and Attitude Towards Obstetric Danger Signs and Maternal Health Care: in Rural Jimma Zone of Ethiopia

Purpose

This study aimed to compare knowledge and attitudes towards obstetric danger signs and care between females receiving maternal care and their male partners.

Methods and Materials

A community-based comparative cross-sectional study was conducted in the rural setting of Jimma, Ethiopia. Female and their male partners were selected randomly. The number of participants included from each sex was 3235 totaling 6470. Face-to-face data collection was employed using open data kit (ODK) software. A pre-test was performed before the data collection. Descriptive and analytical statistical analysis was used to compare knowledge and attitudes regarding obstetric danger signs and care. Predictor variables were declared considering a 95% confidence interval, adjusted odds ratio (AOR) and P-value less than 0.05.

Results

On average, male and female participants identified at least two obstetric danger signs. More females could mention more antenatal, childbirth, and postnatal danger signs than their male partners. Both females and their male partners who listened to the radio at least once per week had a statistically significant positive attitude towards obstetric care. Nonetheless, both had an almost similar magnitude of attitude towards obstetric care irrespective of belonging to different occupational, educational, and other social strata. Males' knowledge of danger signs during pregnancy (95% CI = (1.07-1.62), AOR = 1.32, P < 0.008) and postnatal care (95% CI = (1.16-1.89), AOR = 1.48, P < 0.002) had a statistically significant association with the females utilization antenatal care (ANC) service, though not delivery care (DC) or postnatal (PNC).

Conclusion

There were inequalities in obstetric danger signs knowledge between females and their male partners. Male partners' knowledge of obstetric danger signs is not only significant during pregnancy and delivery but also has a lasting impact on post-natal service utilization, which underscores the importance of their involvement in maternal healthcare.

Gambian Mothers Lack Obstetric Danger Sign Knowledge, But Educational Intervention Shows Promise

Background

The Gambia has the 12th highest maternal mortality rate in the world, with 80% of deaths resulting from avoidable causes. Unawareness of pregnancy danger signs (DS) has been shown to be a barrier to seeking obstetric care, while app-based education intervention has shown promise.

Objective

We aim to assess patient awareness of DS, identify barriers to awareness, and evaluate potential for implementing smartphone-based technologies for education.

Methods

A cross-sectional semi-structured survey was administered to Gambian women (n = 100) across five hospitals/health centers. Data and informed consent were collected via an online survey portal. Analysis included bivariate analysis and descriptive statistics with p < 0.05 significance level. Recall of 0-2 DS per category was classified as "low" knowledge, 3-5 as "moderate" knowledge, and 6+ as "sufficient" knowledge. Cross-category recall was quantified for overall awareness level (0-6 = "low", 7-12 = "moderate", 13+ = "sufficient". N = 28 total DS).

Findings

Although 75% of participants (n = 100) self-perceived "sufficient" knowledge of DS, the average recall was only two (SD = 2, n = 11) pregnancy DS, one labor and delivery DS (SD = 1, n = 8), and one postpartum DS (SD = 1, n = 9). Twenty-one women were unable to recall any danger signs. "Low" awareness was identified in 77% of women, while 23%, and 0% of women showed "moderate" and "sufficient" overall awareness, respectively. Education level was significantly correlated with overall danger sign recall (ρ(98) = .243, p = .015) and awareness level (ρ(98) = .265, p = .008). Monthly income was significantly correlated with awareness level (ρ(97) = .311, p = .002). Smartphone ownership was reported by 76% of women, and 97% expressed interest in using app-based video (94%) or provider (93%) teaching.

Conclusions

Women had low knowledge of obstetric danger signs, and true awareness of danger signs was remarkably lower than self-perceived knowledge. However, patients exhibited proper healthcare-seeking behavior when danger signs arose. Findings suggest that video- or messaging-based education from local healthcare providers may be effective DS educational interventions.

Knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care services at Thai community hospital

BACKGROUND

To decrease preventable maternal mortality, providing health education to all parties is mandatory. Good knowledge, including awareness of pregnant women regarding obstetric danger signs (ODS), leads to appropriate practices and services. The knowledge of ODS varies among countries and regions. Since the data in rural regions of Thailand remains unavailable, this study aimed to identify the prevalence of good ODS knowledge and associated factors among pregnant women attending antenatal services at a Thai community hospital.

METHODS

We performed a cross-sectional, analytical study in 415 singleton pregnant women who visited the antenatal clinic at Wang Saphung Hospital, Loei, Thailand. A well-trained research assistant interviewed all participants using the data record form containing twenty items on the demographic and obstetric data and sixteen items on ODS knowledge. An ODS score of at least 75% (12 points) was considered a good level of knowledge.

RESULTS

A total of 275 participants (66.27%) had good knowledge of ODS. The most recognized ODS was vaginal bleeding whereas the least recognized ODS during pregnancy was convulsion; the least recognized ODS during labor and delivery was retained placenta. Multivariate regression analysis showed that the predictive factors of good OBS knowledge included a higher education level, maternal age of at least 20 years, and having medical personnel as a source of knowledge.

CONCLUSIONS

In a rural setting of Thailand, two-thirds of pregnant women had good ODS knowledge. Identifying those at risk for fair and poor ODS knowledge and prompt management for the vulnerable subgroups might help decrease maternal mortality.

Knowledge of danger signs in pregnancy and their associated factors among pregnant women in Hosanna Town, Hadiya Zone, southern Ethiopia

Background

Danger signs in pregnancy can warn of maternal health problems. In developing African countries, including Ethiopia, the rate of maternal mortality is high. There is little knowledge of danger signs during pregnancy and their associated factors at the community level in the study area.

Methods

A community-based, cross-sectional study was conducted to assess knowledge about danger signs among pregnant women in Hosanna Zuria Kebeles between 30 June and 30 July 2021. A simple random sampling method was used to select eligible pregnant women. The sample size was proportionally allocated based on the number of pregnant women in each kebele. Data were collected in face-to-face interviews using a pretested questionnaire. The descriptive results were presented as proportions, whereas the analytic results were presented as adjusted odds ratios (AOR).

Results

The prevalence of good knowledge of danger signs in pregnancy was 259/410 (63.2%, 95% confidence interval (CI) 58.3–67.8). The most common known danger signs during pregnancy were severe vaginal bleeding (n = 227, 55.4%), followed by blurred vision (n = 224, 54.6%). In the multivariable analysis, the age of the respondent (AOR = 3.29, 95% CI 1.15–9.38), the tertiary education of the mother (AOR = 5.40, 95% CI 2.56–11.34), and the number of live births (AOR = 3.95, 95% CI 2.08–7.48) were statistically significant factors.

Conclusion

There was an adequate prevalence of knowledge of danger signs in pregnancy among pregnant mothers compared with different studies in Ethiopia and different countries. Advanced maternal age, the respondent's level of education, and the number of live births were found to be independent determining factors for the level of knowledge on danger signs in pregnancy among pregnant mothers. Health facilities and healthcare providers should focus on antenatal care and the age and parity of the mother when giving information about danger signs in pregnancy. The Ministry of Health should provide reproductive health services in rural areas and encourage education for women. Further studies need to be conducted and include danger signs in the three trimesters using a qualitative study design.

Assessment of Knowledge about Obstetric Danger Signs and Associated Factors among Pregnant Women in Debre Tabor Town, Northwest Ethiopia

Background

World Health Organization estimates that 800 women die from pregnancy or childbirth-related complications around the world every day. With the assumption that "every pregnancy faces risk" women should be aware of the danger signs of obstetric complications during pregnancy, delivery, and postpartum. Indications on the prevalence of obstetric danger signs and risk factors were crucial in designing programs at different levels in reducing maternal morbidity and mortality.

Objective

To assess the knowledge about obstetric danger signs and associated factors among pregnant women in Debre Tabor town, Northwest Ethiopia, 2021.

Methods

A community-based cross-sectional study was conducted with 295 respondents to assess knowledge about obstetrical danger signs among pregnant women in Debre Tabor town from July to September 2021. Data were collected through self-administered questionnaires. Proportional followed by simple random sampling was used to select the study participants among the pregnant women in each of the six kebeles of the town. Adjusted odds ratios at 95% confidence interval and a value of p < 0.05 were used to identify the predictors.

Results

From a total of 295 interviewed, 61% of them were poorly knowledgeable about obstetric danger signs, but 39% of them were knowledgeable. According to our study, maternal age less than or equal to 30 years (adjusted odds ratio = 5.44; 95% confidence interval: 3.26,9.10), no formal education (adjusted odds ratio = 9.488; 95% confidence interval: 4.73, 13.14), one-time gravidity (adjusted odds ratio = 7.81; 95% confidence interval: 4.79, 9.19), and frequency of antenatal follow-up less than 4 times (adjusted odds ratio = 4.10; 95% confidence interval: 1.88, 8.96) were factors which significantly associated with the poor knowledge of obstetric danger signs.

Conclusion

As the knowledge of pregnant women towards obstetric danger signs was low, maternal age less than or equal to 30 years, no formal education, one-time gravidity, and less than 4 times the frequency of antenatal follow-up are associated factors for poor knowledge on obstetric danger signs.

Do pregnant women prepare and be ready for birth and its complications?

<b>Background:</b> Every pregnancy faces unpredictable complications and risks associated with the risk of maternal morbidity, mortality, and neonatal complications. The aim of the study is to determine birth preparedness and complication readiness (BPCR) among antenatal women and their determinants.<br /> <b>Methods:</b> The involved a total of 100 pregnant women at a public university hospital in Kelantan state, Malaysia. A self-administered questionnaire was used for data collection.<br /> <b>Results:</b> A total of 47.0% of participants were well prepared for their birth and its complications. There were no associations between being well prepared for birth and its complications with parity, gestational age, the total number of antenatal visits, or other sociodemographic data.<br /> <b>Conclusion:</b> BPCR among women were still low among women in Kelantan. Knowledge of the danger signs during pregnancy, labor, and the postnatal period among pregnant women is important to reduce maternal mortality.

Knowledge about Obstetric Danger Signs and Related Factors in Reproductive-Age Women in the Southeast Zone of Tigray, 2021: A Cross-Sectional Study

Background

Pregnancy complications are the major health problems among women in developing countries. Globally, around 295,000 women die from pregnancy-related causes annually and 86% of these maternal deaths happen in developing countries.

Objective

To assess knowledge of obstetric danger signs among reproductive-age women living in southeastern zone of Tigray Region, Ethiopia, 2021.

Methods

A community-based quantitative cross-sectional survey was undertaken in southeastern zone of Tigray. A multistage random sampling technique was implemented to select total participants of 410 reproductive-age women. Two districts were randomly selected, and from those districts, 12 kebeles were selected randomly, and the calculated sample size (410) was proportionally allocated to each selected kebel. The data were collected by using face-to-face interview with a structured questionnaire from January 20 to February 20/2021 after ensuring that all requirements of ethical considerations were fulfilled. The collected data were entered into EpiData version 4.2 and then exported to SPSS version 20 for analysis. Descriptive statistics with frequency, percentage, table and graph, and cross-tabulation were used for presentation of result. Bivariable and multivariable analyses were used to examine the association. Odds ratios with 95% confidence interval and P value < 0.05 were used to determine the statistical association.

Result

Four hundred ten reproductive-age women participated in the study making a response rate of 100%. Leakage of fluid per vagina was the most commonly mentioned obstetric danger signs (61%). Overall, one hundred seventy-two (42%) had good knowledge on obstetric danger sign. Educational status of the mother (AOR (95%CI = 2.7 (1.189-6.24))), site of delivery (AOR (95%CI = 2.2 (1.6-3.432))), and having history of an ANC follow-up (AOR (95%CI = 2.4 (1.13-5.6))) were found to be independent predictors of knowledge of women about the obstetric danger sign. Conclusion and Recommendation. Educational status of the mother site of delivery and having history of an ANC follow-up were independently associated with knowledge of women about obstetric danger signs. Thus, provision of the Information, Education and Communication targeting women, family, and the general community on obstetric danger signs and associated factors was recommended.

Maternal Factors to Prevent Obstetric Complications in Banyumas District, Indonesia

BACKGROUND: The number of pregnant women in the district of Banyumas reached 30,939 in 2012, the number of mothers who detected a high risk reached 20.05%. High-risk pregnant women tend to be more likely to have obstetric complications. The incidence of preeclampsia (8.13%) and hemorrhage (7.27%) is an obstetric complication. Obstetric complication leads to maternal deaths in the district of Banyumas. AIM: This study aims to determine the influence of maternal factors to prevent obstetric complications. METHODS: This study aims to determine the influence of maternal factors to prevent obstetric complications. This type of research is descriptive analytic. This research is using cross-sectional approach. Population this study are pregnant women who are in the subdistricts of Banyumas and Pekuncen. Samples taken as many as 188 pregnant women in both regions. RESULTS: The result showed that as many as 27.1% of women have a risk pregnancy, as many as 36.7% of women had low knowledge about high-risk pregnancy, as many as 47.9% of women have an lack attitude high-risk pregnancy, as many as 41.5% of mothers have poor affordability in antenatal care, and as many as 36.7% of mothers have less family support on high-risk pregnancy. There are influence knowledge, attitudes high-risk pregnancy, and antenatal care affordability toward the prevention of obstetric complication. CONCLUSIONS: Factor most influential in the prevention of obstetric complication is affordability antenatal care.

Magnitude and determinants of knowledge towards pregnancy danger signs among pregnant women attending antenatal care at Chiro town health institutions, Ethiopia

Objectives:

This study aimed to assess the magnitude and determinants of knowledge of pregnancy danger signs in Chiro town health institutions, Ethiopia.

Methods:

Institutional-based cross-sectional study was conducted among 395 systematically selected pregnant mothers. An interviewer-administered pretested questionnaire was used to collect data. The data were entered into EPI data version 3.1 and analyzed using SPSS version 22. Bi- and multivariate logistic regression analyses were used to identify determinant factors. Statistical significance was declared at p < 0.05.

Results:

Even though 58.0% of respondents recalled at least one danger sign of pregnancy, only 26.3% (95% confidence interval: 21.7–30.7) of the respondents had good knowledge of pregnancy danger signs. Residence (adjusted odds ratio = 2.43, 95% confidence interval: 1.50–4.00), distance to health facility (adjusted odds ratio = 2.11, 95% confidence interval: 1.28–3.47), and income (adjusted odds ratio = 1.99, 95% confidence interval: 1.22–3.33) were found to be significantly associated with mothers’ knowledge of pregnancy danger signs.

Conclusion:

The overall women’s knowledge of the danger signs of pregnancy was poor. Monthly income, distance to health facilities, and residence were determinant factors of mothers’ knowledge of pregnancy danger signs. Thus, the provision of information targeting pregnant women, their families, and the general community regarding danger signs of pregnancy is recommended to health care providers.

Global Overview of Response Rates in Patient and Health Care Professional Surveys in Surgery: A Systematic Review

OBJECTIVE

Identify key demographic factors and modes of follow-up in surgical survey response.

SUMMARY BACKGROUND DATA

Surveys are widely used in surgery to assess patient and procedural outcomes, but response rates vary widely which compromises study quality. Currently there is no consensus as to what the average response rate is and which factors are associated with higher response rates.

METHODS

The National Library of Medicine (MEDLINE/PubMed) was systematically searched from Januray 1, 2007 until February 1, 2020 using the following strategy: (((questionnaire) OR survey) AND "response rate") AND (surgery OR surgical). Original survey studies from surgical(-related) fields reporting on response rate were included. Through one-way analysis of variance we present mean response rate per survey mode over time, number of additional contacts, country of origin, and type of interviewee.

RESULTS

The average response is 70% over 811 studies in patients and 53% over 1746 doctor surveys. In-person surveys yield an average 76% response rate, followed by postal (65%) and online (46% web-based vs 51% email) surveys. Patients respond significantly more often than doctors to surveys by mail (P < 0.001), email (P = 0.003), web-based surveys (P < 0.001) and mixed mode surveys (P = 0.006). Additional contacts significantly improve response rate in email (P = 0.26) and web-based (P = 0.041) surveys in doctors. A wide variation in response rates was identified between countries.

CONCLUSIONS

Every survey is unique, but the main commonality between studies is response rate. Response rates appear to be highly dependent on type of survey, follow-up, geography, and interviewee type.

Knowledge of obstetric danger signs and associated factors among pregnant women in Wolaita Sodo town, South Ethiopia: A community-based cross-sectional study

Introduction

Obstetric complications continue to be the major causes of maternal mortality in low- and middle-income countries. Knowledge of women toward obstetric danger signs is an important part of improving maternal and fetal outcomes. However, the reported level of knowledge on obstetric danger signs is low and inconsistent.

Methods

Community-based cross-sectional study design was used. Data were collected from randomly selected 740 pregnant women. A pregnant woman said to have good knowledge of obstetric danger signs if she spontaneously mentioned at least two of the danger signs during each of the three periods (pregnancy, labor/childbirth, and postpartum) and otherwise said to have poor knowledge of obstetric danger signs. Adjusted odds ratio at 95% confidence interval and a value of p < 0.05 were used to identify the predictors.

Results

A total of 740 pregnant women participated in the study with the response rate of 97.5%. One hundred twenty-four (16.8%) of the respondents were knowledgeable about obstetric danger signs. According to our study, age range of 20-24 years (adjusted odds ratio = 6, confidence interval: 2.67-17.44) and 25-29 years old (adjusted odds ratio = 2.4, confidence interval: 1.14-5.10); being housewife (adjusted odds ratio = 0.5, confidence interval: 0.28-0.87); monthly income of ⩽1000ETB (adjusted odds ratio = 0.24, confidence interval: 0.12-0.46) and 1001-2500ETB (adjusted odds ratio = 0.24, confidence interval: 0.12-0.47); and primigravida (adjusted odds ratio = 0.09, confidence interval: 0.04-0.18) and primipara (adjusted odds ratio = 0.15, confidence interval: 0.07-0.30) were factors significantly associated with knowledge of obstetric danger signs.

Conclusion

Knowledge of obstetric danger signs among pregnant women was low. Maternal age, average monthly income, maternal occupation, parity, and gravidity were factors significantly associated with the knowledge of obstetric danger signs.

Spatial Differences in Knowledge and Perception of Key Danger Signs of Pregnancy among Mothers in Ebonyi State, Nigeria

Background

To determine knowledge and perception of key danger signs of pregnancy among mothers in urban and rural communities of Ebonyi state, Nigeria.

Methodology

A comparative cross-sectional study design was used. The two-stage sampling technique was used to select 660 women in four of thirteen local government areas in the state. The women have delivered in last one year irrespective of place of delivery. Outcome measure included good knowledge of danger signs and was assessed by proportion of respondents who recalled four of eight danger signs. Positive perception was assessed by proportion who were aware that danger signs of pregnancy were capable of causing death of women if unattended to immediately.

Results

The mean age of respondents was urban, 29.6±6.2 and rural, 28.6±5.1 years. The most recalled danger sign was bleeding before labour; urban, 280 (84.8%); rural,267 (80.9%). Comparable proportions - urban, 272 (82.4%); rural, 287 (87.0%) had good knowledge of danger signs. (p=0.105). Predictors of good knowledge of danger signs included residing in urban, (AOR=0.4; 95%C1:0.2-0.9), being <30 years, (AOR=0.6; 95%C1:0.3-0.9), having 2-4 children, (AOR=2.4; 95%C1:1.2-4.7) and not receiving antenatal care from a skilled provider. (AOR=0.2; 95%C1:0.08-0.4). There was an association between good knowledge and positive perception of danger signs. (p<0.001).

Conclusions

Majority of respondents in study area had good knowledge and positive perception of danger signs of pregnancy. Consolidating the understanding of danger signs will enhance maternal health outcome thus improving the maternal death burden in Nigeria. There is need to ensure that all women receive antenatal care from a skilled provider.

Pregnancy danger signs: Knowledge and health-seeking behavior among reproductive age women in southwest Ethiopia

Background:

Warning signs of pregnancy are not reliably predictable. But, knowing these early warning signs is very important for pregnant women to eliminate serious complications and start treatment immediately. The higher level of maternal mortality can be reduced by providing quality maternity service and empowering women with good knowledge of the danger signs of pregnancy and promoting appropriate health-seeking behavior. Therefore, this study aimed to assess the knowledge of pregnancy danger signs and health-seeking behavior among reproductive age women in southwest Ethiopia.

Method:

A cross-sectional study was carried out with 526 randomly selected women from 1 to 30 January 2019. The data were collected through face-to-face interviews and analyzed using Statistical Package for the Social Sciences version 21. Both bivariate and multivariable logistic regression analyses were conducted to determine factors associated with the outcome variable. The level of significance was declared at a p-value < 0.05.

Results:

The proportion of mothers who had good knowledge of pregnancy danger signs were 43.2%. The majority (65%) of those surveyed mentioned vaginal bleeding as a pregnancy danger sign. The factors associated with good knowledge of pregnancy danger signs were husbands with secondary education and above (adjusted odds ratio = 2.52, 95% confidence interval (1.08–5.91) monthly income ⩾ 1000 Ethiopian Birr (adjusted odds ratio = 2.64, 95% confidence interval (1.48–4.71) being multigravida (adjusted odds ratio = 2.14, 95% confidence interval (1.17–3.94) and last delivery at the health facility (adjusted odds ratio = 6.84, 95% confidence interval (4.02–11.63) The proportion of mothers who experienced pregnancy danger signs and had good health-seeking behavior was 72.7%.

Conclusion:

The knowledge of pregnancy danger signs among reproductive age women was low in the study area. This indicates the large proportions of women who do not know the danger signs are likely to delay in deciding to seek care when they face the problem. Therefore, empowering women, improving the quality of health information about danger signs during antenatal care follow-up, and promoting institutional delivery are the recommended interventions.

Associations between Maternal and Infant Illness and the Risk of Postpartum Depression in Rural China: A Cross-Sectional Observational Study

This study explored how maternal and infant illness correlated with the risk of postpartum depression in the Chinese Qinba Mountains region. In total, 131 villages comprising 435 families with infants (≤6 months old) were randomly sampled. We collected data on maternal and infant illnesses and maternal health knowledge level. The Depression, Anxiety, and Stress Scale-21 was used to measure the risk of postpartum depression. We used descriptive statistics and multivariate logistic regression for the analysis. Infant overall health status was a risk factor for postpartum depression (odds ratio (OR) = 1.90, 95% Confidence Interval (95% CI) = 1.10~3.28), whereas maternal overall health status was not correlated with postpartum depression (OR = 1.36, 95% CI = 0.55~3.39). For specific illnesses, infants experiencing over two common illnesses in the past two weeks (OR = 1.98, 95% CI = 1.13~3.45) and mothers experiencing over two common pains within two weeks after delivery (OR = 1.77, 95% CI = 1.02~3.08) were risk factors for postpartum depression, whereas infants with mild and severe stunted growth, maternal C-section, and postpartum body mass index (normal or overweight) were not correlated with it (all p > 0.050). Maternal health knowledge was an important moderator of maternal and infant illnesses on the risk of postpartum depression. In conclusion, maternal and infant illness were essential factors for the risk of postpartum depression in a poor rural region in western China, which may be mainly affected by the feeling of uncertainty of illness. Improved maternal and infant health and enhanced maternal health knowledge might alleviate the risk of postpartum depression.

Prevalence and Associated Factors of Early Postnatal Care Service Use Among Mothers Who Had Given Birth Within the Last 12 Months in Adigrat Town, Tigray, Northern Ethiopia, 2018

BACKGROUND

The care given for the first hours, days, and weeks after childbirth is life-threatening. So far, this period receives less attention from health-care providers than the care given to pregnancy and delivery. This study aimed to determine the prevalence and associated factors of early postnatal care service use among mothers who had given birth in the last 12 months in Adigrat Town, Tigray, Ethiopia.

METHODS

A community-based cross-sectional study was conducted from March to April 2018 among 481mothers who had given birth in the last 12 months. A systematic random sampling technique was used to select study participants. A pre-tested and structured questionnaire was used to collect the data. Data analysis was computed using SPSS version 20. An adjusted odds ratio with a 95% confidence interval and p-value less than 0.05 was used to determine the level of significance.

RESULTS

The proportion of early postnatal care service utilization was 34.3% (95% CI: 29.9%-38.5%). Mothers' use of early postnatal care service was predicted by previous early postnatal care use (AOR=2.60, 95% CI: 1.41-4.77), ANC visit (AOR=0.122, 95% CI:0.059-0.251), delivery complication (AOR=5.57, 95% CI: 2.85-10.89), distance (AOR =5.05, 95% CI: 2.45-10.42), postnatal home visit (AOR=0.21, 95% CI: 0.11-0.40), awareness on early postnatal care (AOR=16.38 95% CI: 6.23-43.07), age (AOR=9.34, 95% CI: 1.73-50.27), (AOR=6.50, 95% CI: 2.29-18.41), (AOR= 6.23, 95% CI: 2.38-16.33) and income (AOR=7.97 95% CI: 2.42-26.26, AOR=3.30 95% CI:1.42-7.67).

CONCLUSION

Our study's finding revealed that the prevalence of early postnatal care service use was low. Early postnatal care service use was significantly associated with previous early postnatal care use, delivery complication, distance, postnatal home visit, number of ANC visits, awareness on early postnatal care use, age, and income.

Obstetric Danger Signs: Knowledge, Attitude, Health-Seeking Action, and Associated Factors among Postnatal Mothers in Nekemte Town, Oromia Region, Western Ethiopia-A Community-Based Cross-Sectional Study

Background

Maternal mortality remains unacceptably high due to pregnancy complications and remains the major health problems in many developing countries such as Ethiopia. Having poor knowledge of obstetric danger signs contributes to delays in seeking and receiving skilled care which in turn increases maternal mortality. However, in Ethiopia, studies are lacking regarding the knowledge level of mothers about obstetric danger signs during pregnancy, child birth, and postnatal periods. In Ethiopia, the proportion of those who have full knowledge of these obstetric danger signs during pregnancy, child birth, and postnatal period is not known. Despite few studies are conducted at health facility level focusing on danger signs during pregnancy, the issue of health-seeking action after identifying danger signs and attitude of mothers towards obstetric danger sign was not addressed.

Objectives

To determine knowledge, attitude, health-seeking action towards obstetric danger signs, and associated factors among postpartum women.

Methods

A community-based cross-sectional study was conducted in Nekemte Town from October 1 to November 30, 2017. Multistage sampling technique was employed to select the total sample size of 621. Ethical clearance was obtained from Wollega University research and ethical committee. A pretested structured questionnaire was used to collect data from respondents. Data were entered to EpiData version 3.1 and exported to SPSS version 20 for analysis. To assess the associations between dependent and independent variables, binary and multivariate logistic regressions were employed, and the strength of association was presented using odds ratios with 95% confidence intervals.

Result

Only 197 (32.3%) of respondents were able to spontaneously mention at least five key obstetric danger signs during antepartum, intrapartum, and postpartum (in the three phases) with at least one obstetric danger sign in each phase and thus were considered as having good knowledge of key obstetric danger signs. Government employee (AOR = 3.28, 95% CI: 1.98–5.42), able to read and write (AOR = 4.92, 95% CI: 2.14–11.3), primary school (AOR = 4.90, 95% CI: 2.11–11.4), ANC follow-up (AOR = 6.2, 95% CI: 1.82–21.21), and ANC visit (AOR = 4.07, 95% CI: 2.35–7.06) were significantly associated with knowledge of obstetric danger sign. From 150 (24.6%) participants who faced obstetric danger signs during their last pregnancy, the majority of them, 137 (91.3%), had a good practice which is seeking a health facility for care. Conclusion and Recommendation. Despite their low knowledge level and attitude, the practice of mothers in response to obstetric danger signs was encouraging. Occupation, educational status, ANC follow-up, and number of ANC visits were variables significantly associated with knowledge of obstetric danger signs. Health care providers should provide health education and counseling to increase awareness, and appropriate counseling during antenatal care at each visit is of paramount importance.

Knowledge of obstetric danger signs and associated factors among mothers in Bahir Dar district, northwest Ethiopia: an institution-based cross-sectional study

Background

Like other developing countries, in Ethiopia, obstetric complications contribute to about 50% of the maternal deaths. Thus, the aim of this study was to assess knowledge of obstetric danger signs and its associated factors among mothers attending the postnatal clinic at Felege Hiwot Referral Hospital, Bahir Dar district, northwest Ethiopia.

Methods

A hospital-based cross-sectional study was conducted on 410 postnatal mothers at Felege Hiwot Referral Hospital from June to September 2015. Knowledge of obstetric danger signs among postnatal clinic attending mothers was determined by using seventeen obstetric danger sign questions via interviewing. The binary logistic regression model was used to identify associated factors. In the multivariable analysis, variables with a P value of < 0.05 were considered statistically significant. Odds ratio with 95% confidence interval (CI) was calculated to show the strength of association.

Results

About 59% [95% CI 55, 63] of mothers were knowledgeable about obstetric danger signs. The odds of having good knowledge of obstetric danger signs were higher among mothers who were more educated [AOR = 6.86, 95% CI 2.47, 19.27], earned more than 3500 ETB household monthly income [AOR = 3.38, 95% CI 1.20, 13.96], and received information on danger signs from health extension workers (HEWs) [AOR = 4.23, 95% CI 1.83, 9.70] compared to their counterparts. However, mothers with service utilization decision power [AOR = 0.14, 95% CI 0.07, 0.27] with husband were 86% times less likely to be knowledgeable compared to mothers decided by themselves.

Conclusion

In this study, below two thirds of mothers had good knowledge of obstetric danger signs. Thus, improving educational status and obtaining health information on obstetric danger signs from health professionals should be intensified. This implies that lack of awareness may lead to delay in seeking care. Thus, improving mothers’ socio-economic status and self-decision-making power on utilization of health service are essential to mitigate the high burden of maternal morbidity due to obstetric complications. Also, obtaining health information on obstetric danger signs from health professionals should be intensified.

Knowledge about child birth and postpartum obstetric danger signs and associated factors among mothers in Dale district, Southern Ethiopia

BACKGROUND

Globally, every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. The majority of these deaths occur after childbirth (post-partum period) mostly within 24 h. Raising awareness of women on obstetric danger sign of childbirth and postpartum, are crucial for safe motherhood initiative and to reduce maternal mortality.

METHODS

A community based cross sectional study was conducted from December 15, 2017 up to February 10, 2018 on randomly selected sample of 782 women who had at least one delivery in the last 12 months. Multi stage sampling technique was used to select the study participants. Pre tested structured questionnaire was used to collect quantitative data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20.0 software.

RESULTS

Total 732 women who had at least one birth prior to this survey were interviewed and making a response rate of 93.6%.The most common spontaneously mentioned danger signs during childbirth was Severe vaginal bleeding by 281 (68.4%). Women who could mention at least two danger signs during child birth and post-partum period were 333 (45.5%), 213(29.1%) respectively. Being urban (AOR = 3.54, 95% of CI: [2.20-5.69] and delivered previous birth at health institution (AOR = 3.35, 95% of CI: [2.38-4.72]) were factors found to be significantly associated with knowledge of danger signs during postpartum. Being Attended secondary level and above (AOR = 2.41, 95% of CI: [1.02-7.76]) and use of ANC during last pregnancy (AOR = 3.63, 95% of CI: [2.51-5.25]), were factors found to be significantly associated with knowledge of danger signs during childbirth.

CONCLUSIONS

The level of knowledge about danger signs of child birth and postpartum were low. This indicates that many mothers are more likely to delay in deciding to seek health care. Also, knowledge about danger signs of childbirth and postpartum were affected by place of residence, formal education, use of ANC and place of delivery. Therefore, the identified gap in awareness should be addressed through effective maternal health services by strengthening and designing appropriate strategies including provision of targeted health information, education and communication.

Efficacy of companion-integrated childbirth preparation for childbirth fear, self-efficacy, and maternal support in primigravid women in Malawi

Background

In resource-limited settings, childbirth remains a matter of life and death. High levels of childbirth fear in primigravid women are inevitable. To date, few studies have explored interventions to reduce childbirth fear in primigravid women. This study aimed to evaluate the efficacy of companion-integrated childbirth preparation (C-ICP) during late pregnancy for reducing childbirth fear and improving childbirth self-efficacy, birth companion support, and other selected pregnancy outcomes in primigravid women.

Methods

A quasi-experimental study was carried out using a non-equivalent control group design to recruit a sample of 70 primigravid women in hospital maternity waiting homes in the intervention and control groups, with 35 in each group. The primigravid women and their birth companions in the intervention group received two sessions of companion-integrated childbirth preparation, whereas the control group received routine care. A questionnaire that incorporated the childbirth attitude questionnaire (CAQ), the childbirth self-efficacy inventory (CBSEI), the birth companion support questionnaire (BCSQ), and a review checklist of selected pregnancy outcomes was used to collect data. Pretest and post-test data were analyzed using simple linear regression. Beta coefficients were adjusted at a 95% confidence interval with statistical significance set at a P-value of < 0.05 using Statistical Package for the Social Sciences version 25.

Results

At pretest, mean scores were similar in the intervention and control groups. At post-test, being in the intervention group significantly decreased childbirth fears (β: = − .866, t (68) = − 14.27, p < .001) and significantly increased childbirth self-efficacy (β: = .903, t (68) = 17.30, p < .001). In addition, being in the intervention group significantly increased birth companion support (β: = − 0.781, t (68) = 10.32, p < .001). However, no statistically significant differences regarding pregnancy outcomes were observed between the study groups (Mann–Whiney U test, p > .05).

Conclusion

The findings of our study suggest that C-ICP is a promising intervention to reduce childbirth fear while increasing childbirth self-efficacy and maternal support. We recommend the inclusion of C-ICP for primigravid women during late pregnancy in resource-limited settings.

Knowledge of obstetric danger signs and associated factors: a study among mothers in Shashamane town, Oromia region, Ethiopia

Background

Child birth which is a special moment for parents, families and communities is also a time of intense vulnerability. In many developing countries including Ethiopia, maternal morbidity and mortality still pose a substantial burden. Raising awareness of women about the danger signs of pregnancy and childbirth is the first essential step in appropriate and timely obstetric care.

Objective

To assess the knowledge of obstetric danger signs among mothers and associated factors in Shashamane town, oromia region, Ethiopia.

Methods

A community based cross sectional study design was employed. All kebeles were included in study; the number of households was determined using proportionate-to-population size then systematic random sampling technique to select 422 women who gave birth in Shashamane town between April and May 2018. A structured questionnaire was used to collect data. Data was checked and entered into Epi data version 3.1 then exported to Statistical Package for Social Science version 23 for analysis. Univariate, bivariate and multivariable analysis with 95% CI was carried out. Women who spontaneously mentioned at least two danger signs of pregnancy from eight items were considered to have good knowledge of the obstetric danger signs.

Result

A total of 422 mothers were involved in the study. The mean age of the respondent was 25 with a standard deviation of 4.3 year. 59.5% of the respondents were found to have poor knowledge of obstetric danger signs. Majority of respondents mentioned vaginal bleeding (64.7%) as a danger sign of pregnancy. According to the result of the multivariable analysis, antenatal care was significantly associated with the knowledge of obstetric danger sign. Respondents who attended antenatal care were 1.26 times more likely to have good knowledge of obstetric danger signs than those who had no antenatal care [AOR = 1.26, 95%CI (1.08–1.85)]. Respondents who gave birth at health center were 3.57 time more likely to have good knowledge of obstetric danger signs than those who gave birth at home [AOR = 3.57, 95%CI (1.23–10.39)].

Conclusion

According to this study, the knowledge of obstetric danger signs was poor. Some of the factors associated with this knowledge were antenatal care attendance and place of delivery; therefore, it is recommended that mothers should have at least four antenatal visits; this may create good relationship with the providers and enhance their knowledge. In addition to this providing compassionate and respectful maternity care in health facility is also crucial steps to attract more women to health facilities, and to reduce home deliveries.

Awareness and practice of birth preparedness and complication readiness among pregnant women in the Bamenda Health District, Cameroon

BACKGROUND

Birth preparedness and complication readiness has as goal to reduce maternal and neonatal mortality. This concept developed by the organizations of the United Nations permits pregnant women and their families seek health care without delay in case of obstetric complications and delivery. Though its benefits have been proven in several countries, little is known of this in Cameroon and specifically in the North West Region. Therefore, the intention of the study was to assess the awareness and practice of birth preparedness and complication readiness in this health district.

METHODS

This was a facility-based cross sectional study carried out in the Bamenda health district of the North West Region, Cameroon. Three hundred forty-five pregnant women of ≥32 weeks gestational age seen at the antenatal consultation units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Data collected was analyzed with SPSS and Microsoft excel. Frequency distributions were used to determine the awareness and practice of birth preparedness and complication readiness.

RESULTS

Of the 345 pregnant women included in this study, 159(46.1%) were aware of birth preparedness and complication readiness. The practice of birth preparedness and complication readiness was unsatisfactory as only 65(18.8%) were considered prepared.

CONCLUSION

Education and counselling on birth preparedness and complication readiness is not made available to the pregnant women resulting in poor knowledge. Thus, reflected in the low practice of preparation for birth and its complication observed.

Knowledge of obstetric danger signs and its associated factors among pregnant women in Angolela Tera District, Northern Ethiopia

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.

Effect of Pregnant Mothers' Forum Participation on Birth Preparedness and Complication Readiness among Pregnant Women in Dale District, Southern Ethiopia: A Comparative Cross-Sectional Study

Background

Pregnant mothers' forum is the innovative intervention strategy being implemented in Ethiopia to facilitate birth preparedness and complication readiness practice. However, its effect on birth preparedness and complication readiness has not been investigated.

Objective

This study assessed the association of participation in pregnant mothers' forum with birth preparedness and complication readiness plan among pregnant women in Dale District.

Methods

A community-based comparative cross-sectional study was conducted among 604 pregnant women (302 who were forum members [exposed] and 302 who were forum nonmembers [unexposed]). Multistage sampling technique was used to select respondents. Data were collected door to door using a pretested and structured questionnaire through face-to-face interview. Data were entered and analyzed using SPSS version-20. Multiple logistic regression analysis was used to identify the effect of pregnant mothers' forum membership on birth preparedness and complication readiness adjusting for other variables.

Results

About 22.5% of pregnant women were well prepared for birth. A quarter (25.8%) of the women was prepared for the anticipated complications of whom 20.7% were the forum members. Being pregnant mother's forum member (AOR=2.86, 95% CI=1.50,5.44), having focused counseling (AOR=3.73, 95% CI=1.17,11.83), monthly income (AOR=2.55, 95% CI=1.44,4.51), having antenatal care (AOR=3.73,95% CI=1.05,13.21), and institutional delivery during last birth (AOR=2.41, 95% CI=1.38,4.22) were significantly associated with birth preparedness. Similarly, being forum members (AOR=3.55, 95%CI=2.18, 5.78) and having antenatal care attendance before or at four months of gestational age (AOR=3.16, 95%CI=2.04, 4.91) were found to be predictors of complication readiness.

Conclusion

In this study, birth preparedness and complication readiness is found to be low. However, it was significantly higher among forum members compared to forum nonmembers. Hence, efforts should be targeted to strengthen the pregnant mothers' forum and enroll the pregnant women to antenatal care service at early stage of the pregnancy.

Knowledge of Pregnancy and Its Danger Signs Not Improved by Maternal and Child Health Handbook

Background

High numbers of maternal mortality rate and child mortality rate continue to be the pressing issues in Indonesia. To tackle this problem, multiple approaches have been undertaken, particularly through distributing a Maternal and Child Health (MCH) handbook to every pregnant woman. However, despite the widespread usage of such handbook, its true efficacy in supporting safe motherhood by improving maternal knowledge on various stages of pregnancy and the associated obstetric danger signs is relatively unknown and remains to be established.

Methods

This is a primary cross-sectional study conducted at Majalengka General District Hospital on recently delivering postpartum women between August and September 2017. A total of 127 women were recruited and later divided into two separate groups according to their self-admission on the degree they had read the MCH handbook (≥ 50% and < 50%) and administered a pre-validated questionnaire to assess their knowledge around pregnancy and its danger signs.

Results

We discovered that our population had high knowledge around pregnancy and its danger signs, and the MCH handbook did not hold a significant role in effecting this finding (p value 0.295). Furthermore, various sociodemographic factors (age, educational backgrounds, welfare status, distance from healthcare center, parity and number of ANC visits) also did not exert a statistically significant influence on the level of knowledge in our population (p values 0.579, 0.521, 0.617, 0.908, 0.342, 0.618 and 0.939 respectively).

Conclusion

To conclude, the MCH handbook did not exert a significant influence in improving maternal knowledge levels around pregnancy and the associated obstetric danger signs.

Birth preparedness, readiness planning and associated factors among mothers in Farta district, Ethiopia: a cross-sectional study

BACKGROUND

Birth Preparedness and Complication Readiness (BP/CR) is the process of planning for normal birth and anticipating actions needed in case of emergency. Even though there is no adequate evidences on determinant factors, women and newborn need timely access to skilled care during pregnancy, childbirth, and the postpartum period. The aim of this study was to identify factors associated with the practice of birth preparedness and complication readiness plan among women who gave birth in the last 12 months in Farta District, Ethiopia, 2016.

METHOD

A community-based cross-sectional study was conducted among 676 mothers from 1st October to December, 2016. Multistage sampling technique was used to select study participants. Data were collected using structured and pretested questionnaire. Bivariate and multivariable logistic regression models were fitted to identify factors associated with the practice of birth preparedness and complication readiness plan. An adjusted odds ratio with 95% confidence interval (CI) was computed to determine the level of significant.

RESULT

The percentage of women implementing complication readiness plan and practicing birth preparedness was found to be 34%. Residence [Adjusted odds ratio (AOR): 5.94, 95% CI: 2.28-15.46)]; educational status [AOR: 2.87, 95% CI: (1.27-6.49)]; Antenatal care follow up [AOR: 3.67, 95% CI: (2.10-6.41)]; history of stillbirth [AOR: 3.05, 95CI: (1.20-7.78)]; knowledge of birth preparedness and complication readiness plans [AOR: 8.83, 95% CI: (5.01-15.58)]; knowledge of key danger signs during pregnancy [AOR: 3.91, 95% CI: (2.52-6.06)], child birth [AOR: 2.22, 95CI: (1.45-3.39)] and postpartum period [AOR: 1.99, 95% CI: (1.14-3.48)] were significantly associated with practice of birth preparedness and complication readiness plan.

CONCLUSION

The overall proportion of women who prepared for birth and its complication readiness was found to be low. Educating women, encouraging pregnant women to utilize antenatal care, creating awareness on danger signs during pregnancy and childbirth might increase women's birth preparation and complication readiness plan.

WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis

BACKGROUND

According to the 2015 World Health Organization report, globally, an estimated 10.7 million mothers died from 1990 to 2015 due to obstetric complications. This report showed that almost all global maternal deaths (99%) occurred in developing countries and two thirds of these deaths took place in sub-Saharan Africa where the majority of women lack knowledge about obstetric danger signs. In Ethiopia, in several research reports, it has been indicated that women have poor knowledge about obstetric danger signs. Although several studies have been conducted to assess women's knowledge of obstetric danger signs, to date, no systematic review has been conducted in Ethiopia. Therefore, this review is aimed at synthesising the existing literature about women's knowledge of obstetric danger signs.

METHODS

We systematically searched for articles from MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, Scopus, Google Scholar and Maternity and Infant Care databases. A combination of search terms including 'knowledge' or 'awareness' or 'information' and 'pregnancy danger signs' or 'obstetric danger signs' or 'obstetric warning signs' and 'Ethiopia' was used to locate appropriate articles. Two reviewers conducted article screening and data abstraction independently. Observational studies published in English and conducted in Ethiopia to date were assessed for quality using the adapted Newcastle Ottawa Scale for cross-sectional studies. The PRISMA checklist was used to present the findings of this systematic review.

RESULTS

From the 215 articles initially screened by abstracts and titles, 12 studies fulfilled the inclusion criteria. All the studies reported women's knowledge of obstetric danger signs during pregnancy, ten articles reported on the level of knowledge during delivery and eight studies reported on the level of knowledge of danger signs during the postpartum period. The pooled random effect meta-analysis level of women's knowledge about obstetric danger signs during pregnancy, delivery and postpartum was 48%, 43% and 32%, respectively. Maternal age, education, income, health service use, distance from facility and women's autonomy were reported in several studies as determinants of women's knowledge of obstetric danger signs.

CONCLUSIONS

Women's knowledge about obstetric danger signs in Ethiopia was very poor, which could hamper access to obstetric care when women encounter obstetric complications. Counselling services during antenatal care and community-based health information dissemination about obstetric danger signs should be strengthened.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017077000.

What he knows about her and how it affects her? Husband's knowledge of pregnancy complications and maternal health care utilization among tribal population in Maharashtra, India

Background

Husbands’ knowledge and awareness of pregnancy complications have a positive impact on their wives’ utilization of maternal health care services. In this study, we examined whether husbands’ knowledge and awareness of pregnancy complications can serve as determinants of maternal health service utilization among wives from the tribal population.

Methods

This cross-sectional study was conducted in the rural Gadchrioli district of Maharashtra, India, during November 2014–March 2015. This study included a representative population-based sample of 385 men whose wives had given birth in last 2 years at the age of 15–49 years. A multistage sampling strategy was adopted to select the respondents. Univariate, bivariate, and binary logistic regression analyses were applied to examine the association between men’s knowledge and maternal health service utilization.

Results

The result revealed that an increase in husbands’ education level increased the wives’ utilization of antenatal (ANC) care services. The type of tribe also contributed to significant differences in ANC utilization (OR: 2.64; 95% CI: 0.847–8.24). Regarding standard of living, husbands who were poor were 22% less likely than husbands in the rich category to report the utilization of ANC by their wives. Men with partial or complete knowledge of pregnancy, childbirth, and postpartum complications were more likely to utilize all maternal health services by their wives.

Conclusions

The wives are of men who aware of complications during pregnancy and childbirth are more likely to use maternal health services. Therefore, educating and empowering men about pregnancy complications will contribute to the reduction in maternal and neonatal deaths.

Electronic supplementary material

The online version of this article (10.1186/s12884-019-2214-x) contains supplementary material, which is available to authorized users.

Women's knowledge of maternal danger signs during pregnancy: Findings from a cross-sectional survey in Papua New Guinea

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.

Assessment of knowledge of obstetric danger signs among pregnant women attending a teaching hospital

Introduction

Knowledge of obstetric danger signs among pregnant women is of paramount importance in improving maternal, and fetal health outcomes. This study aims to determine the knowledge of danger signs among pregnant women seeking antenatal care in a teaching hospital.

Materials and Methods

A cross-sectional study was carried out for two months among pregnant women who visited the antenatal clinic of a teaching hospital. A pre-tested and pre-designed proforma was used. Mean knowledge scores were computed and knowledge was classified into adequate and inadequate.

Results

A total of 170 pregnant women fulfilling the inclusion criteria were included. Mean age of the study participants was found to be 26.40 ± 4.14 years. Nearly 67.10% were aware of bleeding per vagina being a danger sign, 50.0% stated excessive vomiting as a danger sign, 23.50% knew that blurring of vision was a danger, while a mere 20.0% reported that convulsions were a danger sign. Overall, adequate knowledge (total knowledge score of 5 and above) was observed in 54.70% of the participants.

Conclusion

Majority of the study participants had adequate knowledge of danger signs in pregnancy. However, when knowledge about specific individual danger signs were further assessed, a high proportion had very poor knowledge. The mean knowledge scores were found to be low.

Level and determinants of birth preparedness and complication readiness among pregnant women: A cross sectional study in a rural area in Bangladesh

BACKGROUND

Increasing the level of birth preparedness and complication readiness (BP/CR) is one of the key interventions to promote optimal utilization of skilled maternal health services. It is therefore essential to determine the women's ability to recognize the danger signs and the level of BP/CR. This information can be used to design more effective health interventions.

OBJECTIVES

This study was conducted to determine the knowledge in recognition of maternal complications, and the level and factors associated with BP/CR in rural Matlab, Bangladesh.

METHODS

A community-based cross-sectional survey was conducted from June- October 2015 on a randomly selected 2262 women who delivered live or stillbirth during the year 2014. A pretested and structured questionnaire was used for data collection. Descriptive and analytical statistical methods were used.

RESULTS

The proportion of study participants with "good knowledge", measured by the ability to recognise three or more danger signs, in pregnancy and delivery were 26% and 23%, respectively. Out of four BP/CR components, about 15% women saved money, 12% women identified facility for delivery, 9.6% women planned to deliver by skilled birth attendant and 5.3% of women arranged transport. About 12% of women were "well prepared", measured by planning of at least two components, for skilled childbirth and emergency obstetric complications. In the multivariable logistic regression analysis, asset index, antenatal care (ANC) visits and knowledge of danger signs during pregnancy and delivery were associated with BP/CR. The adjusted odds ratio (OR) of "well prepared" was 4.09 (95% confidence interval [CI]: 2.45-6.82) among women with an asset index of five (richest), compared with women in the asset index of one (poorest). The odds of "well prepared" was six times (OR 5.98, 95% CI: 3.85-9.28) higher for women with four or more ANC visits, compared to women with none or one ANC visit. In comparison to women with "poor knowledge" on maternal danger signs during pregnancy and delivery, the odds ratio of "well prepared" among women with good knowledge during pregnancy and in delivery were 1.95 (95% CI: 1.44-2.63) and 1.74 (95% CI: 1.28-2.36), respectively.

CONCLUSION

The study revealed a low level of maternal knowledge of danger signs and BP/CR among pregnant women. Further, low socioeconomic status, fewer ANC visits and poor knowledge in recognition of dangers signs on maternal health were associated with low BP/CR. More emphasis should be placed on the quality of information offered to the pregnant women during the prenatal contact and women from low socio-economic gradient should be prioritized to optimize the impact of future BP/CR interventions.

Cross-sectional survey of knowledge of obstetric danger signs among women in rural Madagascar

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.

Knowledge of obstetric danger signs among recently-delivered women in Chamwino district, Tanzania: a cross-sectional study

Background

Low knowledge of danger signs has been shown to delay seeking obstetric care which leads to high maternal mortality and morbidity worldwide. In Tanzania about half of pregnant women are informed about obstetric danger signs during antenatal care, but the proportion of those who have full knowledge of these obstetric danger signs is not known. This study assessed the knowledge of obstetric danger signs and its associated factors among recently-delivered women in Chamwino District, Tanzania.

Methods

A community-based cross-sectional study was conducted in January 2014 in Chamwino District, Tanzania. A woman was considered knowledgeable if she spontaneously mentioned at least five danger signs in any of the three phases of childbirth (pregnancy, childbirth and postpartum) with at least one in each phase. Multistage cluster sampling was used to recruit study participants. Descriptive and bivariate analyses were conducted. Multivariable logistic regression analyses were performed to control for confounding and other important covariates.

Results

A total of 428 women were interviewed. The median age (IQR) was 26.5 (22–33) years. Only 25.2% of respondents were knowledgeable about obstetric danger signs during pregnancy, childbirth/labour and postpartum. Significant explanatory variables of being knowledgeable about obstetric danger signs were found to be maternal education (AOR = 1.96; 95% CI: 1.01, 3.82), maternal occupation (AOR = 2.23; 95% CI; 1.10, 4.52), spouse occupation (AOR = 2.10; 95% CI: 1.02, 4.32) and counseling on danger signs (AOR = 3.42; 95% CI: 1.36, 8.62) after controlling for the clustering effect, confounding and important covariates.

Conclusion

A low proportion of women was found to be knowledgeable about obstetric danger signs in Chamwino district. Therefore, we recommend the Ministry of Health to design and distribute the maternal health booklets that highlight the obstetric danger signs, and encourage antenatal care providers and community health workers to provide frequent health education about these danger signs for every pregnant woman in order to increase their level of knowledge about obstetric danger signs.

Knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care at health facilities of Yirgacheffe town, Gedeo zone, Southern Ethiopia

BACKGROUND

Obstetric danger signs are not the literal obstetric complications, merely symptoms that are well named by non-clinical personnel. The identification of these danger signs and its relation with complications during pregnancy would increase the capacity of women, their partners and families to seek for timely health care, following the appropriate steps to insure a safe birth and post-partum. The aim of this study was to assess the knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care in Yirgacheffe town, Gedeo zone, Southern Ethiopia.

METHOD

Institutional-based cross-sectional study was conducted from March 15-April 15, 2016. Data on pregnant women were collected using a pre-tested and interviewer administered structured questionnaire from 342 women using systematic random sampling technique. Bivariate and multivariate logistic regression was performed using SPSS version 20.0 software.

RESULT

A total of 342 (90%) pregnant women were included in the study. The level of obstetric knowledge of danger signs was 21.9% (95% CI: 20.2-55.65%). Maternal education (AOR = 0.26, CI: 0.08, 0.88), paternal education (AOR = 0.13, CI; 0.04, 04) and time taken to reach health facilities on foot (AOR = 0.06, CI: 0.02, 0.17) were negatively associated factors while maternal age (AOR = 3.68, CI: 1.30, 10.46), paternal occupation (AOR = 4.65, CI: 1.82, 11.87), place of residence (AOR = 2.61, CI: 1.35, 5.04) were positively associated factors with knowledge of obstetric danger signs.

CONCLUSION

Maternal and paternal education, maternal age, paternal occupation, place of residence and time taken to reach health facility on foot were the main factors for knowledge of obstetric danger signs. Increasing knowledge of key danger signs, creating and promoting income generating mechanisms need to be continuously done at the health facility and the community as it makes ready women and their families for prompt and appropriate decisions and measures in case of obstetric danger signs.

Knowledge of direct obstetric causes of maternal mortality and associated factors among reproductive age women in Aneded woreda, Northwest Ethiopia; a cross-sectional study

Introduction

in Ethiopia, 20,000 women die each year from complications related to pregnancy and childbirth with much more maternal morbidity occurring for each maternal death. Good knowledge of women related with direct causes of maternal mortality is important in reducing maternal morbidity and mortality. Therefore, the aim of this study was to assess knowledge of direct obstetric causes of maternal mortality and associated factors among reproductive age of women in Aneded woreda, Northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted using multi-stage sampling followed by simple random sampling technique. The study was conducted in Aneded woreda, Northwest Ethiopia. A total of 844 reproductive age women were included in the study. Pre-tested semi-structured questionnaire was used to collect the data. Data was collected through face-to-face interviews by 12 data collectors. Data was cleaned, coded and entered into Epi-data, then exported and analyzed using SPSS software. Bivariate and multivariable logistic regression analysis were computed to identify factors related to knowledge of obstetric causes of maternal mortality. The crude and adjusted odds ratios together with their corresponding 95% confidence intervals (CI) were computed. A P-value less than 0.05 was used to declare statistical significance.

Results

This study found that almost half (49.6%) of respondents have good knowledge level towards obstetric causes of maternal mortality. Significant variables associated with knowledge towards obstetric causes of maternal mortality were; being government employee (AOR=3.6, 95% CI=1.4-8.9), respondents who had additional monthly income from family members (AOR=1.54, 95% CI=1.04-2.27), respondents who attended primary school and above (AOR=1.6, 95% CI=1.13-2.25), distance of health facility in which the time it took less than 20 minutes (AOR=2.25, 95% CI(1.24-4.09), 20-39minutes (AOR=3.06, 95% CI=1.66-5.64), 40-60 minutes (AOR=2.38, 95% CI=1.52-5.26), and previous history of prolonged labor (AOR=1.4, 95% CI=1.04 -2.03) were the significant variables.

Conclusion

This study indicated that the reproductive age women in the study area had poor knowledge towards about obstetric causes of maternal mortality. Therefore, to improve maternal knowledge and thereby reduce maternal death, the identified significant factors should be addressed through maternal and child health services. Designing appropriate strategies including the provision of targeted information, education, and communication is important.

The effect of social behavior change communication package on maternal knowledge in obstetric danger signs among mothers in East Mamprusi District of Ghana

Background

An understanding of maternal knowledge of the danger signs of obstetric and newborn complications is fundamental to attaining universal health coverage. In Northern Ghana, where maternal and newborn morbidity and mortality is high, little is known about the current knowledge level and associated determinants of these danger signs. This study assessed the effect of social behavior change communication (SBCC) package on knowledge of obstetric and newborn danger signs among mothers with children under 24 months of age.

Methods

This study used a non-randomized controlled community-based intervention design with pre and post-intervention household surveys in the intervention and comparison communities of the East Mamprusi District in Ghana. The study population were selected using a two-stage cluster sampling procedure.

Result

Only 521 (51.1%), 300 (29.4%) and 353 (34.6%) of the study participants knew at least three key danger signs during pregnancy, delivery and postpartum period respectively.

The intervention had a positive effect on maternal knowledge of danger signs. Compared to their counterparts in the comparison communities, women in the intervention communities were about 2.6 times (AOR  =  2. 58 [CI: 1.87, 3.57]), 3.4 times (AOR  =  3.39 [CI: 2.31, 4.96]) and 2.2 times (AOR  =  2.19 [CI: 1.68, 2.84]) more likely to have higher knowledge of danger signs of childbirth, postpartum and neonate, respectively.

Having sought postnatal services at least once was significantly associated with the mentioning of at least three danger signs of postpartum (AOR  =  3.90 [CI: 2.01, 7.58]) and childbirth (AOR  =  1.75 [CI: 1.06, 2.85]).

Conclusion

There was a significant contribution of social and behavioral change communication as an intervention to maternal knowledge in obstetric danger signs after adjusting for confounding factors such as antenatal and post-natal care attendance. Therefore, provision of information, education and communication targeting women on danger signs of pregnancy and childbirth and associated factors would be an important step towards attaining universal health coverage.

Knowledge of obstetric danger signs and associated factors among reproductive age women in Raya Kobo district of Ethiopia: A community based cross-sectional study

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.

Birth preparedness and complication readiness among rural women of reproductive age in Abeshige district, Guraghe zone, SNNPR, Ethiopia

Background

Birth preparedness and complication readiness (BPCR) is a strategy that helps women to consider all available maternal health care services during pregnancy and prepare for potential complications. Federal Ministry of Health in Ethiopia has taken steps to roll out the strategy at community level. Yet, women in rural communities still do not make use of available services to avoid complications in connection to pregnancy and delivery.

Objective

This study aims to assess the current BPCR practice and determine associated factors among rural women of reproductive age in Abeshige district, Guraghe zone, SNNPR, Ethiopia.

Methods

A community-based cross-sectional study was carried out from February to March 2015. A total of 454 women were randomly selected and interviewed using pretested structured questionnaires, while opinion leaders, health extension workers, and selected women in the community were engaged in in-depth interviews and focus group discussions, using checklists prepared to guide the interviews. Data from different sources were analyzed, triangulated, and interpreted to respond to the objectives.

Results

Thirty-seven percent of the respondents were found to have prepared for birth and its complications. BPCR was higher among women who lived within a 1-hour walk from a health center (adjusted odds ratio [AOR] =3.51, 95% confidence interval [CI]: 1.78, 36.79) and who were aware of the danger signs of pregnancy (AOR =1.72, 95% CI: 1.78, 2.94) and postpartum complications (AOR =2.32, 95% CI: 1.32, 4.21). A major source of information was found to be health extension workers and one-to-five women networks (AOR =2.81, 95% CI: 1.34, 6.21) and (AOR =2.52, 95% CI: 1.17, 5.54), respectively. Qualitative finding revealed that lack of transportation and concern over cost of services are key barriers to BPCR.

Conclusion

BPCR in Abeshige was found to be relatively low, calling for more interventions beyond mere awareness. Availing transportation services and ensuring services free of charge would help in improving BPCR in the study area.

Knowledge about Danger Signs of Obstetric Complications and Associated Factors among Postnatal Mothers of Mechekel District Health Centers, East Gojjam Zone, Northwest Ethiopia, 2014

Background. Developing countries like Ethiopia contributed highest level of maternal mortality due to obstetric complications. Women awareness of obstetric danger sign to recognize complications to seek medical care early is the first intervention in an effort to decrease maternal death. Objective. To assess knowledge about danger signs of obstetric complications and associated factors among postnatal mothers at Mechekel district health centers, East Gojjam zone, Northwest Ethiopia, 2014. Methods. An institution based cross-sectional study was conducted from August to October, 2014, in Mechekel district health centers. Systematic random sampling was used to select four hundred eleven study participants. A pretested structured questionnaire was used to collect data. Data were entered to Epi Info version 3.5.3 and exported to SPSS 20.0 for further analysis. Descriptive and summary statistics were done. Logistic regression analyses were used to see the association of different variables. Odds ratios and 95% confidence interval were computed to determine the presence and strength of association. Results. According to this study, 55.1% participants were knowledgeable about danger signs of obstetric complications. Maternal and husband educational level ((AOR = 1.977, 95% CI: 1.052, 3.716) and (AOR = 3.163, 95% CI: 1.860, 5.3770), resp.), family monthly income ≥ 1500 (AOR = 2.954, 95% CI: 1.289, 6.770), being multipara (AOR = 7.463, 95% CI: 1.301, 12.800), ANC follow-up during last pregnancy (AOR = 2.184, 95% CI: 1.137, 4.196), and place of last delivery (AOR = 1.955, 95% CI: 1.214, 3.150) were variables found to be significantly associated with women's knowledge on danger signs of obstetric complications. Conclusion. Significant proportion of respondents were not knowledgeable about obstetric danger signs and factors like educational status, place of last delivery, and antenatal follow-up were found to be associated.

Knowledge of obstetric danger signs and associated factors among pregnant women in Erer district, Somali region, Ethiopia

BACKGROUND

Knowledge of danger signs of obstetric complications is first step in the appropriate and timely referral to essential obstetric care. Although women's knowledge about the obstetric danger signs is important for improving maternal and child health, little is known about the current knowledge and influencing factors in pastoral community of Ethiopia. This study, therefore, aims to fill this gap by assessing the current level of knowledge and associated factors of pregnant women living in Erer district of Somali region, Ethiopia.

METHODS

A community based, cross-sectional study was conducted from April 7 to 21, 2014. The study involved 666 pregnant women residing in the district. Two-stage sampling technique was used to select the study subjects. Data about women's socio-demographic information, reproductive history, knowledge of the danger signs, exposure to media and interventions were collected by interviewer administered questionnaires. A respondent who spontaneously mentioned at least two of the danger signs during each of the three periods was considered knowledgeable; otherwise not. Descriptive, bivariate, then multivariable logistic regression were done.

RESULTS

Six hundred thirty two pregnant women were interviewed with a response rate of 94.9 %. Only 98 (15.5 %) respondents were knowledgeable about obstetric danger signs. Urban residence [AOR = 2.43; 95 % CI (1.40, 4.21)], women who had been pregnant five or more times [AOR = 6.65; 95 % CI (2.48, 17.89)] and antenatal care utilization [AOR = 5.44; 95 % CI (3.26, 9.09)] were associated with being knowledgeable about obstetric danger signs during pregnancy, childbirth and postpartum.

CONCLUSION

A significant proportion of pregnant women in Erer district do not have knowledge of obstetric danger signs. The implication is that lack of recognition may lead to delay in seeking care. Area of residence, gravidity and antenatal care service utilization are independently associated with the knowledge of women on obstetric danger signs in Erer district, a pastoralist community. Thus, intervention programs aiming to improve women's knowledge about obstetric danger signs and symptoms should consider the factors independently associated.

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

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.

Using Young Mothers' Clubs to Improve Knowledge of Postpartum Hemorrhage and Family Planning in Informal Settlements in Nairobi, Kenya

Women living in Nairobi's informal settlements face a higher risk of maternal death than those living elsewhere in the country, and have limited knowledge of actions they can take to improve their chances of survival during pregnancy and childbirth. As one strategy to reach this high risk group, Jhpiego has implemented young mothers' clubs (YMCs). These clubs comprise mothers aged 18-30 who come together on a weekly basis to share experiences and solutions to their challenges while receiving health education from health facility staff and community health workers (CHWs). The aim of this study was to assess whether the YMC strategy could be used to improve participants' knowledge of postpartum hemorrhage (PPH), positive behavior around childbirth, and family planning. Participants in nine YMCs (n = 193) across four informal settlements were interviewed to assess their knowledge of safe motherhood topics before and after a series of eight health education sessions. Data were analyzed with the McNemar test to determine significance of change in knowledge pre- and post-intervention. The largest improvements were observed in knowledge about what to include in a birth plan, with correct responses increasing from 32 to 73% (p < 0.001), 58-93% (p < 0.001), 36-66% (p < 0.001), 58-85% (p < 0.001), and 64-88% (p < 0.001) for identifying a birth companion, budget, skilled birth attendant, emergency supplies, and place of birth, respectively. Less substantial improvements were observed in knowledge of danger signs of PPH (up 10% from 77%, p = 0.003). Although knowledge of actions to take in the event of bleeding after delivery did significantly improve, final knowledge scores remained low--knowledge to urinate increased from 14 to 28% (p < 0.001) and to breastfeed from 12 to 24% (p = 0.005). Even though the vast majority of respondents (84%) knew before the intervention that a woman should space pregnancy by at least 2 years after delivery, there was an increase to 94% after the sessions (p = 0.008). Overall, participants demonstrated significant improvements in knowledge of safe motherhood and family planning topics, suggesting that the materials and methods used were generally effective for improving knowledge among this high risk group.

Birth preparedness and complication readiness among women of Bankura District, West Bengal

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 which is critical in averting maternal morbidity and mortality.

Objectives:

To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Bankura, West Bengal.

Materials and Methods:

A cross-sectional, community-based study was carried out among 120 pregnant women and 235 recently delivered women. Information on sociodemographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. For statistical analysis Z-test was used.

Results:

The majority of respondents (69.3%) had registered for antenatal care within the first 12 weeks of their pregnancy and 74.0% of the recently delivered women had four or more antenatal check-ups and 81.3% had institutional delivery. The BPCR index of pregnant women and recently delivered women was 45.2 and 59.0, respectively, whereas BPCR index of the total was 52.1.

Conclusion:

Although the BPCR indicators are satisfying, the health system should use the opportunity during visits to health institutions to increase awareness among the pregnant women and her family on how to plan for the pregnancy and identify danger signs.

Birth preparedness and complication readiness - a qualitative study among community members in rural Tanzania

BACKGROUND

Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR.

DESIGN

A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data.

RESULTS

The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees.

CONCLUSIONS

This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers.

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

Background

Men’s involvement in reproductive health is recommended. Their involvement in antenatal care service is identified as important in maternal health. Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care. This study aims to assess the level of knowledge of obstetric complications among men in a rural community in Tanzania, and to determine their involvement in birth preparedness and complication readiness.

Methods

A cross-sectional survey was conducted where 756 recent fathers were invited through a two-stage cluster sampling procedure. A structured questionnaire was used to collect socio-demographic characteristics, knowledge of danger signs and steps taken on birth preparedness and complication readiness. Data were analyzed using bivariate and multivariable logistic regression to determine factors associated with being prepared, with statistically significant level at p<0.05.

Results

Among the invited men, 95.9% agreed to participate in the community survey. Fifty-three percent could mention at least one danger sign during pregnancy, 43.9% during delivery and 34.6% during the postpartum period. Regarding birth preparedness and complication readiness, 54.3% had bought birth kit, 47.2% saved money, 10.2% identified transport, 0.8% identified skilled attendant. In general, only 12% of men were prepared. Birth preparedness was associated with knowledge of danger signs during pregnancy (AOR = 1.4, 95% CI: 1.8-2.6). It was less likely for men living in the rural area to be prepared (AOR=0.6, 95% CI; 0.5-0.8).

Conclusion

There was a low level of knowledge of obstetric danger signs among men in a rural district in Tanzania. A very small proportion of men had prepared for childbirth and complication readiness. There was no effect of knowledge of danger signs during childbirth and postpartum period on being prepared. Innovative strategies that increase awareness of danger signs as well as birth preparedness and complication readiness among men are required. Strengthening counseling during antenatal care services that involve men together with partners is recommended.

Factors Associated with Men’s Awareness of Danger Signs of Obstetric Complications and Its Effect on Men’s Involvement in Birth Preparedness Practice in Southern Ethiopia, 2014

Background. Compared to average maternal mortality ratio of 8 per 100,000 live births in industrialized countries, Ethiopia has an estimated maternal mortality ratio of 676 per 100,000 live births. Maternal deaths can be prevented partially through increasing awareness of danger signs of obstetric complications and involving husbands (male) in birth preparedness practice.Methods. Community based cross-sectional study was done. All adult males with a wife or partner who lives in the selected kebeles were our study population. Data was collected by pretested and structured questionnaires and two-stage cluster sampling procedure was used in order to collect study samples. Data was cleaned and entered into Epi Info 7 and exported to SPSS (IBM-21) for further analysis. Ordinary and hierarchical logistic regression model were used and AOR with 95% CI were used to show factors and the effect of men’s awareness of danger sign on men’s involvement in birth preparedness practice.Results. Total numbers of men interviewed were 836 making a response rate of 98.9%. 42% of men had awareness of danger sign and 9.4% (95% CI: (7.42, 11.4) of men were involved in birth preparedness practice. Respondents who live in the rural area [(AOR: 8.41; (95% CI: (4.99, 14.2)], governments employee [(AOR: 3.75; (95% CI: (1.38, 10.2)], those who belong to the highest wealth quintile [(AOR: 3.09; (95% CI: (1.51, 6.34)], and husbands whose wives gave birth in the hospital [(AOR: 2.09; (95% CI: (1.29, 3.37)], health center [(AOR: 1.99; (95% CI: (1.21, 3.28)], and health post [(AOR: 2.2; (95% CI: 2.16 (1.06, 404)] were positively associated and those who had no role in the health development army [(AOR: 0.43; (95% CI: (0.26, 0.72)] were negatively associated with men’s awareness of danger signs of obstetric complications.Conclusion. The prevalence of men awareness of danger sign was low and male involvement in birth preparedness practice was very low. Since there is a low level of awareness (17.1%) particularly in the urban area and men act as gatekeepers to women’s health, the respective organization needs to review urban health extension program and give due emphasis to husband education in order that they are able to recognize danger signs of obstetric complications in a way to increase their involvement in birth preparedness practice.