Birth preparedness and complication readiness practice and associated factors among pregnant women in Northwest Ethiopia: 2018

Predictors of Birth Preparedness and Complication Readiness Practices Among Pregnant Women in Ethiopia, a Systematic Review and Meta-Analysis

Objectives

We conducted this review to identify factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Ethiopia. BPCR is a comprehensive approach that helps address delays in seeking care for obstetric problems.

Methods

PRISMA was followed and different databases were used to find studies. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was used to identify factors. The I2 statistic, funnel plot, and Egger test were used to assess the heterogeneity of studies and publication bias.

Results

Knowledge of BPCR, danger signs during pregnancy, labor, and postpartum (AOR = 1.99, 95% CI: 1.51, 2.64, AOR = 1.55; 95% CI: 1.35, 1.80; AOR = 1.45; 95% CI: 1.27, 1.63, and AOR = 1.4; 95% CI: 1.21, 1.63), respectively, residency (AOR = 1.49; 95% CI: 1.32, 1.68), antenatal care visit (AOR = 1.59; 95% CI: 1.43, 1.78), history of stillbirth (AOR = 1.58; 95% CI: 1.36, 1.86), and educational status (AOR = 1.62: 95% CI: 1.45, 1.78) were significantly associated with BPCR practice.

Conclusion

This study identified some modifiable factors in the practice of BPCR. Integrating counseling and expanding ANC services in health facilities may improve BPCR practice.

Effect of male partners' involvement and support on reproductive, maternal and child health and well-being in East Africa: A scoping review

Background and Aims

East African countries have high rates of maternal and child mortality and morbidity. Studies have shown that the involvement of male partners in reproductive health can benefit maternal and child health (MCH). This scoping review aims to provide an overview of the evidence across East Africa that describes male partner involvement and its effect on maternal, reproductive, and child well-being.

Methods

Ten databases were searched to identify quantitative data on male's involvement in East Africa. Studies reporting qualitative data, "intention to use" data or only reporting on male partner's education or economic status were excluded. Studies were organized into five a priori categories: antenatal care (ANC), human immunodeficiency virus, breastfeeding, family planning, and intimate partner violence with further categories developed based on studies included.

Results

A total of 2787 records were identified; 644 full texts were reviewed, and 96 studies were included in this review. Data were reported on 118,967 mothers/pregnant women and 15,361 male partners. Most of the studies (n = 83) were reported from four countries Ethiopia (n = 49), Kenya (n = 14), Tanzania (n = 12) and Uganda (n = 10). The evidence indicates that male partner involvement and support is associated with improved reproductive, MCH across a wide range of outcomes. However, the studies were heterogeneous, using diverse exposure and outcome measures. Also, male partners' lack of practical and emotional support, and engagement in violent behaviors towards partners, were associated with profound negative impacts on MCH and well-being.

Conclusions

The body of evidence, although heterogeneous, provides compelling support for male involvement in reproductive health programs designed to support MCH. To advance research in this field, an agreement is needed on a measure of male partner "involvement." To optimize benefits of male partners' involvement, developing core outcome sets and regional coordination are recommended.

Completion and predictors of maternity continuum of care among women in the post-partum period in Gedeb district, southern Ethiopia: A community based cross-sectional study

INTRODUCTION

Maternal and neonatal complications related to pregnancy and childbirth pose a significant risk of morbidity and mortality to both the mother and the child. Despite its benefits in reducing maternal and neonatal mortality and morbidity associated with pregnancy and childbirth, the majority of Ethiopian mothers were dropped from the maternal continuum of care. Furthermore, there is a dearth of data regarding the status of the maternal continuum of care and its underlying factors in southern Ethiopia.

OBJECTIVE

This study aimed to assess the completion of the maternity continuum of care and its predictors among postpartum women who had given birth in the previous six months in the Gedeb district of Gedio Zone, southern Ethiopia.

METHODS

A community-based cross-sectional survey was conducted among 625 postpartum women selected by simple random sampling from June 1 to 30, 2022. The data was collected through face-to-face interviews using pretested, structured questionnaires. The association between the explanatory variables and the maternity continuum of care was examined using bivariate and multivariable logistic regression models. The adjusted odds ratio (AOR) with a 95% confidence interval was employed to measure the strength of association and the level of significance was set at p<0.05.

RESULTS

In this study, only 32.00% (95% CI: 28.45, 35.77) of the women completed the maternal continuum of care. Attending primary education (AOR = 2.09; 95% CI: 1.23, 3.55), secondary and above education (AOR = 1.97; 95% CI: 1.01, 3.87), receiving counseling during ANC (AOR = 1.89; 95% CI: 1.22, 2.92), being well prepared for birth and complications readiness (AOR = 4.13; 95% CI: 2.23, 7.62), and having good knowledge of pregnancy danger signs (AOR = 4.13; 95% CI: 2.60, 6.55) were all significantly associated with completing the maternity continuum of care.

CONCLUSION

Nearly one-third of the women completed the maternity continuum of care. Enhancing women's knowledge, offering counseling during prenatal visits, ensuring women's awareness of pregnancy danger signs, and implementing health promotion programs targeted at enhancing birth preparedness and complications readiness for all are crucial.

Birth preparedness and complication readiness among recently delivered women in Hargeisa town, Somaliland: A community-based cross-sectional study

BACKGROUND

About 287,000 mothers lost their lives due to pregnancy and delivery in 2020 worldwide. Birth preparedness and complication readiness (BPCR) is an approach used to utilize the timely use of skilled maternal and neonatal services. Preparing mothers for childbirth and against its dangers has great importance in reducing maternal mortality. Little is known about BPCR and influencing factors in Hargeisa town, Somaliland.

OBJECTIVE

To assess the level of BPCR and its associated factors among recently delivered women in Hargeisa.

METHODS

A community-based cross-sectional study was carried out in September 2022 among 300 women who delivered in the one-year time interval before the study period. A census was done to identify the women, and then they were selected by simple random sampling. Face-to-face interviews were conducted using a pre-structured questionnaire. A woman was considered prepared for birth if she made preparations for at least three of the BPCR components. Data were cleaned, entered, and analyzed using SPSS V.25. Bivariate and multivariate logistic regression analyses were performed with a cut-point of 0.05 significance level.

RESULTS

From a total of 300 women, 38.3% had good knowledge of BPCR, and only one-fourth (25%) were prepared for birth and its complications. Access and media usage (AOR = 9.64, CI 1.09-82.248), receiving health education about BPCR (AOR = 3.75, CI 1.01-13.87), giving birth at health institutions (AOR = 6.02, CI 1.39-25.95), and good knowledge of key danger signs of pregnancy (AOR = 0.017, CI 0.004-0.069) were factors significantly associated with BPCR practice.

CONCLUSION

The study identified that the BPCR level was very low compared to many other studies. Such a low BPCR level may have a negative impact on maternal health and lives, hindering interventions conducted to reduce maternal mortality rates. All concerned bodies should consider the importance of awareness creation regarding BPCR in their core interventions.

Spatial variation and predictors of missing birth preparedness and complication readiness (BPCR) messages in Ethiopia

BACKGROUND

The Birth Preparedness and Complication Readiness (BPCR) message is one of the prenatal care packages targeted at reducing maternal and neonatal mortality by avoiding unnecessary delays during labor and delivery. There is limited evidence in Ethiopia that has looked at the spatial variation of missing BPCR messages and potential predictors. Hence, this study aimed to identify spatial predictors missing BPCR messages at the national level.

METHODS

The study was based on analysis of 2016 Ethiopia Demographic Health Survey data, using a weighted sample of 4771 women. Arc-GIS version 10.7 and SaTScan version 9.6 statistical software were used for the spatial analysis. To explore spatial variation and locate spatial clusters of missing BPCR messages, the Global Moran's I statistic and Bernoulli-based spatial scan (SaTScan) analysis were carried out, respectively. Hotspot (Getis-OrdGi*) analysis was conducted to identify Hotspots and Cold spotsof missing BPCR messages. Finally, spatial regression were carried out via ordinary least squares and geographically weighted regression to identify predictors of hotspots for missing BPCR messages.

RESULTS

The overall prevalence of missing BPCR messages in Ethiopia was found to be 44.0% (95%CI: 42.6, 45.4%), with significant spatial variation across regions (Moran's I = 0.218, p-value<0.001) and seven most likely significant SaTScan clusters. The vast majority of Somali, central Afar, and Gambella regions were identified as statistically significant hotspots. Living in the poorest wealth quintile, having only one ANC visit, lack of access to listening to the radio, facing difficulty in accessing money, not having a mobile phone, and being not covered by health insurance were identified as significant spatial predictors of missing BPCR messages.

CONCLUSION

The level of missing BPCR messages during pregnancy was found to be high in Ethiopia, with significant local variation. As a result, policymakers at the national level and local planners should develop strategies and initiatives that enhance women's economic capacities, health-seeking behavior, and media exposure. Furthermore, the regional authorities should focus on strategies that promote universal health coverage through enrolling citizens in health insurance schemes.

Magnitude and factors associated with birth preparedness and complication readiness among pregnant women in Wolaita Zone, Ethiopia

OBJECTIVE

To assess the magnitude and factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Humbo district, Wolaita Zone, Ethiopia.

METHODS

A community-based cross-sectional study was conducted from August 1 to 30, 2020. A total of 506 pregnant women were randomly selected and interviewed using a questionnaire. Data were entered using EpiData version 4.6.0, and analysis was made using SPSS version 24. An adjusted odds ratio (aOR) with a 95% confidence interval (CI) was calculated.

RESULTS

The magnitude of BPCR in the Humbo district was 26.0%. The odds of being prepared for birth and its complications were higher among women who had a history of obstetric complications (aOR 2.77; 95% CI 1.18-6.52), participated in pregnant women's conferences (aOR 3.84; 95% CI 2.13-6.93), received advice on BPCR (aOR 2.39; 95% CI 1.36-4.22), and were knowledgeable on labor and childbirth danger signs (aOR 2.64; 95% CI 1.55-4.49).

CONCLUSION

The magnitude of birth preparedness and complication readiness was low in the study area. The healthcare provider should encourage the women to participate in conferences and provide continuous counseling during their prenatal care visits.

Factors influencing birth preparedness and complication readiness among childbearing age women in Thatta district, Sindh

Introduction

Birth preparedness and complication readiness (BPCR) is a broad system to increase the practice of trained health provision at the time of childbirth and the key interventions to decrease mothers’ and newborns’ death. However, its status and influencing factors have not been well studied at different levels in the study area. The current study aimed to assess the BPCR status and explore its associated factors influencing BPCR among childbearing age women in Thatta, District of Sindh.

Methods

This community-based cross-sectional study was conducted among 770 recently delivered mothers from October 2016 –September 2017, recruited using a multistage cluster sampling technique. A structured validated close-ended questionnaire measuring BPCR knowledge and practices was used for the interviews. The results were analyzed by means of the Chi-square test, and a binary logistic regression model was used to determine the factors influencing BPCR.

Results

The overall response rate was 94.6%, with a low BPCR status. Out of 770 participants, only 163 (21.2%) were well prepared, while 607 (78.8%) were not prepared for safe childbirth and its complications. A small proportion of women knew about the serious warning signs of pregnancy, labour, childbirth and the postpartum period (16.2%), (15.3%) and (22.7%) respectively. Antenatal care (ANC) checkup (P < 0.001), cost of ANC checkup (p = 0.016), place of birth (p = 0.014), awareness of serious warning signs during pregnancy (p = 0.001) and awareness of serious warning signs during the postpartum period (p < 0.001) were found to be significant predictors of BPCR.

Conclusion

The proportion of women who were well prepared for birth and its complications was low. It is recommended to organize community-based education campaigns and improve the quality of MNCH services at every level to increase BPCR among women in Sindh.

Safer motherhood - birth preparedness and complication readiness assessment among pregnant women residing in urban slums of Marathwada region

Background

Birth Preparedness and Complication Readiness (BPACR) is the intervention for planning of normal birth and anticipating the actions needed in case of complications. It is a comprehensive strategy to improve the use of skilled providers at birth, the key measure to reduce maternal mortality.

Objectives

To assess the status of BPACR and associated sociodemographic factors among pregnant women in community.

Materials and Methods

A community-based descriptive longitudinal study undertaken at urban slums among 156 pregnant women with >28 weeks of gestation. They were interviewed for BPACR components.

Results

BPACR index was observed to be lower 48.3%. About 88% were aware about any one danger signs of pregnancy. Nearly, 77% of women availed antenatal care service in first trimester. About 85% women identified skilled birth attendant and mode of transport for delivery, 66% women saved money for delivery. Most common danger sign noted was abdominal pain (65.38%). Mother's education, occupation, parity, and socioeconomic condition were significantly associated with three out of four components of BPACR.

Conclusion

Low level of BPACR index was attributed to low level of awareness regarding government sponsored schemes and danger signs of pregnancy. This highlights need of more efforts in services provided by health care providers and workers. There is need of intense Information, Education and Communication activity focused on pregnant women and their family members.