Does knowledge of danger signs of pregnancy predict birth preparedness? A critique of the evidence from women admitted with pregnancy complications

Health Research Policy and Systems

Dan K Kaye³  Nelson Kakande¹  Michael O Osinde²  Othman Kakaire³  Annettee Nakimuli³  Scovia N Mbalinda⁴ 

[1] Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, P. O. Box 10005, Kampala, Uganda;Department of Obstetrics and Gynecology, Jinja Regional Hospital, Jinja, Uganda;Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda;Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda

关键词: Maternal near miss;    Complication readiness;    Birth preparedness;    Knowledge about danger signs;    Childbirth;    Pregnancy;   

Others  :  1177317
DOI  :  10.1186/1478-4505-12-60

 received in 2014-02-26, accepted in 2014-09-29,  发布年份 2014

【 摘 要 】

Background

Improved knowledge of obstetric danger signs, birth preparedness practices, and readiness for emergency complications are among the strategies aimed at both enhancing utilization of maternal health services and increasing access to skilled care during childbirth, particularly for women with obstetric complications. It is unclear whether knowledge of danger signs translates into improved birth preparedness and complication readiness. The objective was to assess the association between knowledge of danger signs and birth preparedness among women admitted with pregnancy complications.

Methods

The study included 810 women admitted in the antepartum period to Mulago hospital, Uganda. Data was collected on socio-demographic characteristics, reproductive history, pregnancy complications, knowledge of danger signs, and birth preparedness/complication readiness (BPCR). Logistic regression analyses were conducted to explore the relationship between knowledge of danger signs and birth preparedness.

Results

Only about 1 in 3 women were able to mention at least three of the five basic components of BPCR, and could be regarded as ‘knowledgeable on BPCR’. One in every 4 women could not mention any of the five components. Women with history of obstetric problems during the previous pregnancy were more likely to be knowledgeable on danger signs when compared to those who had no complications in prior pregnancy. Women who were knowledgeable on danger signs were four times more likely to be knowledgeable on BPCR as compared to those who were not knowledgeable.

Conclusions

Though awareness about danger signs was low, knowledge of danger signs was associated with knowledge of birth preparedness. More emphasis should be given to emergency/complication readiness during antenatal care sessions. There is a need to strengthen existing policy interventions to address birth preparedness and complication readiness for obstetric emergencies.

【 授权许可】

   
2014 Mbalinda et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Moran AC, Sangli G, Dineen R, Rawlins B, Yaméogo M, Baya B: Birth-preparedness for maternal health: findings from Koupéla District, Burkina Faso. J Health Popul Nutr 2006, 24(4):489-497.
• [2]WHO: Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF and UNFPA. Geneva: World Health Organization; 2004.
• [3]Hussein J, Kanguru L, Astin M, Munjanja S: The effectiveness of emergency obstetric referral interventions in developing country settings: a systematic review. PLoS Med 2012, 9(7):e1001264.
• [4]Paxton A, Maine D, Freedman L, Fry D, Lobis S: The evidence for emergency obstetric care. Int J Gynaecol Obstet 2005, 88(2):181-193.
• [5]Graham W, Themmen E, Bassane B, Meda N, De Brouwere V: Evaluating skilled care at delivery in Burkina Faso: principles and practice. Trop Med Int Health 2008, 13(Suppl 1):6-13.
• [6]Pembe AB, Carlstedt A, Urassa DP, Lindmark G, Nystrom L, Darj E: Effectiveness of maternal referral system in a rural setting: a case study from Rufiji district, Tanzania. BMC Health Serv Res 2010, 10:326. BioMed Central Full Text
• [7]The Ministry of Heath Uganda: Health Sector Strategic Plan 2010/11-2014/15. http://www.health.go.ug/docs/HSSP_III_2010.pdf webcite Accessed 10 February 2014
• [8]Thaddeus S, Maine D: Too far to walk: maternal mortality in context. Soc Sci Med 1994, 38:1091-1110.
• [9]JHIPEGO; Maternal and Neonatal Health (MNH) Program: Birth Preparedness and Complication Readiness: A Matrix of Shared Responsibilities. 2001. http://www.jhpiego.org/files/bpcrmatrix.pdf webcite
• [10]Markos D, Bogale D: Birth preparedness and complication readiness among women of child bearing age group in Goba woreda, Oromia region, Ethiopia. BMC Pregnancy Childbirth 2014, 14(1):282. BioMed Central Full Text
• [11]Tura G, Afework MF, Yalew AW: The effect of birth preparedness and complication readiness on skilled care use: a prospective follow-up study in Southwest Ethiopia. Reprod Health 2014, 11:60. BioMed Central Full Text
• [12]Kaso M, Addisse M: Birth preparedness and complication readiness in Robe Woreda, Arsi Zone, Oromia Region, Central Ethiopia: a cross-sectional study. Reprod Health 2014, 11:55. BioMed Central Full Text
• [13]Pembe AB, Urassa DP, Carlstedt A, Lindmark G, Nystrom L, Darj E: Rural Tanzanian women’s awareness of danger signs of obstetric complications. BMC Pregnancy Childbirth 2009, 9:12. BioMed Central Full Text
• [14]Kabakyenga JK, Östergren PO, Turyakira E, Pettersson KO: Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda. Reprod Health 2011, 8:33. BioMed Central Full Text
• [15]Mulogo EM, Witte K, Bajunirwe F, Nabukera SK, Muchunguzi C, Batwala VK, Bagenda F, Farr C, Barry S: Birth plans and health facility based delivery in rural Uganda. East Afr Med J 2006, 83(3):74-83.
• [16]Magoma M, Requejo J, Campbell OM, Cousens S, Filippi V: High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention. BMC Pregnancy Childbirth 2010, 10:13. BioMed Central Full Text
• [17]Mutiso SM, Qureshi Z, Kinuthia J: Birth preparedness among antenatal clients. East Afr Med J 2008, 85(6):275-283.
• [18]Kakaire O, Kaye DK, Osinde MO: Male involvement in birth preparedness and complication readiness for emergency obstetric referrals in rural Uganda. Reprod Health 2011, 8:12. BioMed Central Full Text
• [19]JHPIEGO: Monitoring Birth Preparedness and Complication Readiness: Tools and Indicators for Maternal and Newborn Health. Baltimore, MD: JHPIEGO; 2004:1-19.
• [20]Stanton CK: Methodological issues in the measurement of birth preparedness in support of safe motherhood. Eval Rev 2004, 28(3):179-200.
• [21]Magoma M, Requejo J, Merialdi M, Campbell OM, Cousens S, Filippi V: How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania. BMC Pregnancy Childbirth 2011, 11:64. BioMed Central Full Text
• [22]Hailu M, Gebremariam A, Alemseged F, Deribe K: Birth preparedness and complication readiness among pregnant women in Southern Ethiopia. PLoS One 2011, 6(6):e21432.
• [23]Onayade AA, Akanbi OO, Okunola HA, Oyeniyi CF, Togun OO, Sule SS: Birth preparedness and emergency readiness plans of antenatal clinic attendees in Ile-ife, Nigeria. Niger Postgrad Med J 2010, 17(1):30-39.
• [24]Ekabua JE, Ekabua KJ, Odusolu P, Agan TU, Iklaki CU, Etokidem AJ: Awareness of birth preparedness and complication readiness in southeastern Nigeria. ISRN Obstet Gynecol 2011, 2011:560641.
• [25]McDonagh M: Is antenatal care effective in reducing maternal morbidity and mortality? Health Policy Plan 1996, 11(1):1-15.
• [26]Agarwal S, Sethi V, Srivastava K, Jha PK, Baqui AH: Birth preparedness and complication readiness among slum women in Indore city, India. J Health Popul Nutr 2010, 28(4):383-391.
• [27]Mrisho M, Schellenberg JA, Mushi AK, Obrist B, Mshinda H, Tanner M, Schellenberg D: Factors affecting home delivery in rural Tanzania. Trop Med Int Health 2007, 12(7):862-872.
• [28]Iliyasu Z, Abubakar IS, Galadanci HS, Aliyu MH: Birth preparedness, complication readiness and fathers’ participation in maternity care in a northern Nigerian community. Afr J Reprod Health 2010, 14(1):21-32.
• [29]Tetui M, Ekirapa EK, Bua J, Mutebi A, Tweheyo R, Waiswa P: Quality of Antenatal care services in eastern Uganda: implications for interventions. Pan Afr Med J 2012, 13:27.
• [30]Asp G, Odberg Pettersson K, Sandberg J, Kabakyenga J, Agardh A: Associations between mass media exposure and birth preparedness among women in southwestern Uganda: a community-based survey. Glob Health Action 2014, 7:22904.
• [31]Aarnio P, Chipeta E, Kulmala T: Men’s perceptions of delivery care in rural Malawi: exploring community level barriers to improving maternal health. Health Care Women Int 2013, 34(6):419-439.
• [32]Kaye DK, Kakaire O, Nakimuli A, Osinde MO, Mbalinda SN, Kakande N: Male involvement during pregnancy and childbirth: men’s perceptions, practices and experiences during the care for women who developed childbirth complications in Mulago Hospital, Uganda. BMC Pregnancy Childbirth 2014, 14(1):54. BioMed Central Full Text
• [33]McPherson RA, Khadka N, Moore JM, Sharma M: Are birth preparedness programmes effective? Results from a field trial in Siraha district, Nepal. J Health Popul Nutr 2006, 24:479-488.
• [34]Aboud FE, Singla DR: Challenges to changing health behaviours in developing countries: a critical overview. Soc Sci Med 2012, 75:589-594.
• [35]Mpembeni RN, Killewo JZ, Leshabari MT, Massawe SN, Jahn A, Mushi D, Mwakipa H: Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy Childbirth 2007, 7:29. BioMed Central Full Text
• [36]McFarlin BL: Elective cesarean birth: issues and ethics of an informed decision. J Midwifery Womens Health 2004, 49:421-429.
• [37]Little MO, Lyerly AD, Mitchell LM, Armstrong EM, Harris LH, Kukla R, Kuppermann M: Mode of delivery: toward responsible inclusion of patient preferences. Obstet Gynecol 2008, 112(4):913-918.
• [38]Thompson R, Miller YD: Birth control: to what extent do women report being informed and involved in decisions about pregnancy and birth procedures? BMC Pregnancy Childbirth 2014, 14(1):62. BioMed Central Full Text
• [39]Essendi H, Mills S, Fotso J-C: Barriers to formal emergency obstetric care services’ utilization. J Urban Health 2011, 88(Suppl 2):356-369.
• [40]Cole-Ceesay R, Cherian M, Sonko A, Shivute N, Cham M, Davis M, Fatty M, Wieteska S, Baro M, Watson D, Phillips B, Macdonald R, Hayden B, Southall D: Strengthening the emergency healthcare system for mothers and children in the Gambia. Reprod Health 2010, 7:21. BioMed Central Full Text
• [41]Lee ACC, Lawn JE, Cousens S, Kumar V, Osrin D, Bhutta ZA, Wall SN, Nandakumar AK, Syed U, Darmstadt GL: Linking families and facilities for care at birth: What works to avert intrapartum-related deaths? Int J Gynaecol Obstet 2009, 107(Suppl 1):S65-S88.