Knowledge of safe motherhood among women in rural communities in northern Nigeria: implications for maternal mortality reduction

Reproductive Health

Benson Obonyo²  Ibrahim Yisa²  Mustapha Tanko²  Adekunle Akerele²  Susan Aradeon¹  Ekechi Okereke² 

[1] Mannion Daniels, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria;Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria

关键词: Northern Nigeria;    Millennium Development Goals;    Maternal mortality;    Safe motherhood;   

Others  :  805269
DOI  :  10.1186/1742-4755-10-57

 received in 2013-05-15, accepted in 2013-10-11,  发布年份 2013

【 摘 要 】

Background

Most developed countries have made considerable progress in addressing maternal mortality, but it appears that countries with high maternal mortality burdens like Nigeria have made little progress in improving maternal health outcomes despite emphasis by the Millennium Development Goals (MDGs). Knowledge about safe motherhood practices could help reduce pregnancy related health risks. This study examines knowledge of safe motherhood among women in selected rural communities in northern Nigeria.

Methods

This was a cross-sectional study carried out in two states (Kaduna and Kano States) within northern Nigeria. Pretested, interviewer-administered questionnaires were applied by female data collectors to 540 randomly selected women who had recently delivered within the study site. Chi-square tests were used to determine possible association between variables during bivariate analysis. Variables significant in the bivariate analysis were subsequently entered into a multivariate logistic regression analysis. The degree of association was estimated by odds ratio (OR) and 95% confidence interval (CI) between knowledge of maternal danger signs and independent socio-demographic as well as obstetric history variables which indicated significance at p< 0.05.

Results

Over 90% of respondents in both states showed poor knowledge of the benefits of health facility delivery by a skilled birth attendant. More than 80% of respondents in both states displayed poor knowledge of the benefits of ANC visits. More than half of the respondents across both states had poor knowledge of maternal danger signs. According to multivariate regression analysis, ever attending school by a respondent increased the likelihood of knowing maternal danger signs by threefold (OR 2.63, 95% CI: 1.2-5.8) among respondents in Kaduna State. While attendance at ANC visits during most recent pregnancy increased the likelihood of knowing maternal danger signs by twofold among respondents in Kano State (OR 2.05, 95% CI: 1.1-3.9) and threefold among respondents in Kaduna State (OR 3.33, 95% CI: 1.6-7.2).

Conclusion

This study found generally poor knowledge about safe motherhood practices among female respondents within selected rural communities in northern Nigeria. Knowledge of safe pregnancy practices among some women in rural communities is strongly associated with attendance at ANC visits, being employed or acquiring some level of education. Increasing knowledge about safe motherhood practices should translate into safer pregnancy outcomes and subsequently lead to lower maternal mortality across the developing world.

【 授权许可】

   
2013 Okereke et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray C: Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millenium Development Goal 5. Lancet 2010, 375:1609-1623.
• [2]WHO: The Safe Motherhood Initiative and beyond. Bull World Health Organ 2007, 85:10. http://www.who.int/bulletin/volumes/85/10/07-045963/en/ (Accessed March 4th, 2013).
• [3]UNICEF: Tracking progress in maternal, newborn & child survival. Geneva: UNICEF; 2008.
• [4]World Health Organization: Maternal and newborn health: framework for the promotion and implementation of community-based interventions. Geneva: AFR/MPS/04.01; 2004.
• [5]Elder J, Ayala G, Harris S: Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med 1999, 17:275-284.
• [6]National Population Commission (NPC) (2009) ICF Macro: Nigeria demographic and health survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro; 2008.
• [7]Abimbola S, Okoli U, Olubajo O, Abdullahi MJ, Pate MA: The Midwives Service Scheme in Nigeria. PLoS Med 2012, 9(5):e1001211.
• [8]Adegoke AA, Lawoyin TO, Ogundeji MO, Thomson AM: A community based investigation of avoidable factors of maternal mortality in Nigeria: the pilot experience. Afr Health Sci 2007, 7(3):176-181.
• [9]Harrison KA: Childbearing, health and social priorities: a survey of 22,774 consecutive births in Zaria, Northern Nigeria. Br J Obstet Gynaecol 1985, 92(suppl 5):1-119.
• [10]Harrison KA: The importance of the educated healthy woman in Africa. Lancet 1997, 349:644-647.
• [11]Jammeh A, Sundby J, Vangen S: Barriers to emergency obstetric care services in perinatal deaths in rural gambia: a qualitative in-depth interview study. ISRN Obstet Gynecol. 2011, 2011:981096.
• [12]Sharma M: Knowledge, attitude and belief of pregnant women towards safe motherhood in a rural Indian setting. Social Sciences Directory 2012, 1:1.
• [13]Mushi D, Mpembeni R, Jahn A: Knowledge about safe motherhood and HIV/AIDS among school pupils in a rural area in Tanzania. BMC Pregnancy Childbirth 2007, 7:5. BioMed Central Full Text
• [14]Roth DM, Mbizvo MT: Promoting safe motherhood in the community: the case for strategies that include men. Afr J Reprod Health 2001, 5(2):10-21.
• [15]Pembe AB, Urassa DP, Anders C, Gunilla L, Lennarth N, Elisabeth D: Rural Tanzanian women's awareness of danger signs of obstetric complications. BMC Pregnancy Childbirth 2009, 9:12. BioMed Central Full Text
• [16]National Population Commission (NPC) [Nigeria]: Final Results of the 2006 National Population and Housing Census of Nigeria. Abuja, Nigeria: National Population Commission; 2009.
• [17]National Population Commission (NPC) [Nigeria]: Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICT Macro; 2009.
• [18]Wolf M, Abubakar A, Tsui S, Williamson NE: Child spacing attitudes in northern Nigeria. VI: FHI: Arlington; 2008.
• [19]Aktar S: Health care seeking behavior for safe motherhood: findings from Rural Bangladesh. Bangladesh e J Sociol 2012, 9(2):57-70.
• [20]Bhatta BN: Public Health Awareness Building in the field of Safe Motherhood. J Nepal Health Res Counc 2008, 6(13):69-73.
• [21]Mushi D, Mpembeni R, Jahn A: Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care The case of Mtwara Rural District in Tanzania. BMC Pregnancy Childbirth 2010, 10:14. BioMed Central Full Text
• [22]Anya SE, Hydara A, Jaiteh LE: Antenatal care in the Gambia: missed opportunity for information, education and communication. BMC Pregnancy Childbirth 2008, 8:9. BioMed Central Full Text
• [23]Idris SH, Gwarzo UM, Shehu AU: Determinants of place of delivery among women in a semi-urban settlement in Zaria, northern Nigeria. Ann Afr Med 2006, 5:68-72.
• [24]Idris SH, Sambo MN, Ibrahim MS: Barriers to utilization of maternal health services in a semi-urban community in northern Nigeria: the clients’ perspective. Niger Med J 2013, 54:27-32.
• [25]Haliu M, Gebremariam A, Alemseged F: Knowledge about Obstetric Danger Signs among Pregnant Women in Aleta Wondo District, Sidama Zone, Southern Ethiopia. Ethiop J Health Sci 2010, 20(1):25-32.
• [26]Gabrysch S, Campbell OMR: “Still too far to walk: literature review of the determinants of delivery service use,”. BMC Pregnancy Childbirth 2009, 9:34. BioMed Central Full Text
• [27]Setal P, Whiting D, Hemed Y, Alberti KG: Educational status is related to mortality at community level in three areas of Tanzania, 1992–1998. J Epidemiol Community Health 2000, 54(12):936-937.
• [28]Urassa E, Lindmark G, Nystrom L: Maternal mortality in Dar es Salaam, Tanzania: Socio-economic, obstetric history and accessibility of health care factors. Afr J Health Sci 1995, 2(1):242-249.
• [29]Garenne M, Mbaye K, Bah MD, Correa P: Risk factors for maternal mortality: a case study in Dakar hospitals (Senegal). Afr J Reprod Health 1997, 1(1):14-24.
• [30]Prata N, Sreenivas A, Vahidnia F, Potts M: Saving maternal lives in resource-poor settings: facing reality. Health Policy 2008, 89(2):131-148.