Husbands’ participation in birth preparedness and complication readiness plan in Kucha district, Gamo Zone, Southern Ethiopia

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. The involvement of husband during pregnancy helps a mother to make timely decisions to avoid delays. Identifying the level of husband involvement in Birth-preparedness and complication-readiness is very important, as husband is the major decision maker in household and health service related issue. However, there is no sufficient data in the Kucha district, which describes the level of husband involvement in Birth-preparedness and complication-readiness. Therefore, this study assessed the level of husband involvement in birth preparedness and complication readiness in Kucha District, Gamo Zone, Ethiopia. Methods Community-based cross-sectional study was conducted on 421 husbands whose wife gave birth within the last 12 months at Kucha District using simple random sampling technique. Data was collected using a pretested interviewer-administered questionnaire by trained data collectors. Binary and multivariable logistic regression with odds ratios along with the 95% confidence interval analysis were employed to find factors associated with the level of husband involvement. A p-value <0.05 with 95% confidence level used to decide statistical significance. Results Data were collected from 421 study participants. One hundred twenty-seven (30.2%) were involved in birth preparedness and complication readiness plan. Participants who had at least secondary school education AOR = 3.1, CI (1.84–5.23), had at least four antenatal care visits AOR = 4.91, CI (2.36–10.2), and live more than five km from the health care facility AOR = 2.35, CI = 1.40–3.96) were involved in birth preparedness and complication readiness plan. Conclusion Husbands’ involvement in birth preparedness and complication readiness was low. Husband’s higher educational level, high frequency of antenatal care, and long distance to the health facility were significantly associated with husbands’ involvement in Birth-preparedness and complication-readiness plan. Therefore, advocating for higher frequency of antenatal care and improving educational level are important to increase husbands’ involvement in birth preparedness and complication readiness plan.

Emergency caesarean section and its sequelae in a tertiary hospital in Niger Delta, Nigeria

Background: Caesarean section (CS) is one of the most common surgical procedure in obstetrics. It involves a surgical incision made through the abdominal and uterine walls to deliver the foetus and placenta after the period of foetal viability.Methods: This was a cross-sectional study aimed at reviewing emergency caesarean section in Rivers State University Teaching Hospital (RSUTH) over a 5-year period, to determine the prevalence and sequelae. Data were analysed using IBM Statistical Product and Service Solution (SPSS) version 25.0 (Armonk, NY).Results: During the review period, there were 13516 deliveries and 3699 cases of emergency CS, giving the prevalence of emergency CS as 27.4% or 274 per 1000 deliveries. Majority (90%) of the parturient were unbooked. The most common complication in women that had emergency caesarean section was fever (56.4%), followed by endometritis (14.7%), absconding from hospital (8.8%), urinary tract infection (7.1%) and wound infection (6.1%). There was a statistically significant association between types of CS and their sequelae, χ2=1153.9, p<0.001, (95% CI: 0.000, 0.000). Women that had emergency CS were 101 times more likely to have a complication compared to those that had planned CS.Conclusions: The rate of emergency caesarean section is high in RSUTH and with more complications compared to planned caesarean section. Booking for antenatal care, early presentation for delivery, birth preparedness and complication readiness will enhance improved maternal and perinatal outcome.

The dropout rate and associated factors of the continuum of maternal health care services before and during Covid-19 Pandemic among women who gave birth in the last two years in Addis Ababa, Ethiopia, 2021. A comparative cross-sectional study design

Background A continuum of maternal health care is the continuity of care during pregnancy, delivery, and post-delivery period. However, the dropout rate of the continuum care and factors associated with it during the COVID-19 pandemic were not well documented in the study setting. Hence, this study was used to assess the dropout rate and associated factors of the continuum of care before and during the COVID-19 pandemic. Methods A community-based comparative cross-sectional study was conducted among 630 women who gave birth in the last two years in Addis Ababa. An interviewer-administered questionnaires were used to collect the data. The Epi data version 4.6 and STATA version 14 statistical Softwares were used for data entry and analysis, respectively. Binary logistic regression model was used to identify associated factors of the dropout rate of a continuum of care. Result The dropout rate of the continuum of maternal healthcare was 58.39% (95% CI: 52.56-64.00) and 73.24% (95% CI: 67.91-77.98) before and during the covid-19 pandemic respectively. Women who had no information about PNC (AOR =1.88, 95% CI: 1.01-3.50), not received appropriate care (AOR = 3.92, 95% CI: 1.84-8.37), no information about maternal health care (AOR=2.57, 95% CI: 1.28-5.16), birth preparedness and complication readiness (AOR=0.47, 95% CI: 0.26-0.86), and had history of pregnancy-related complications (AOR=2.07, 95% CI: 1.17-3.68), were dropped out from continuum of care during the covid-19 pandemic. whereas, unplanned pregnancy (AOR= 3.35, 95% CI: 1.60-7.04), not know postpartum danger signs (AOR=1.79,95% CI: 1.03-3.12), and no information about maternal health care (AOR= 1.85, 95% CI: 1.06-3.23) were dropped out from continuum of care before covid-19 pandemic. Conclusion This study underscores nearly three fourth and more than half of women during and before the covid-19 pandemic dropped out from the continuum of care, respectively. Information about maternal health care, birth preparedness and complication readiness, information about PNC, and knowing postpartum danger signs were significantly associated with the dropout rate of the continuum of care. Thus, adapting policy that supports service delivery modification during such pandemic, promoting birth preparedness and complication readiness is very crucial.

BIRTH PREPAREDNESS AND COMPLICATION READINESS OF WOMEN IN NIGERIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Introduction Globally, efforts are being made to reduce the menace of maternal death in order to achieve the sustainable development goal. Maternal death has been associated with inadequate birth preparedness and complication readiness especially in the low and middle income countries. Therefore, this review assessed birth preparedness and complication readiness in Nigeria. Methods A systematic review and meta-analysis of published research articles on birth preparedness and complication readiness in Nigeria was done using PubMed, EMBASE and MEDLINE databases. All published articles from inception to November, 2018 were included in the review. A total of 8913 published articles were identified from electronic search, a total of 4440 studies were included in this review, while only 12 articles met the inclusion criteria and were included in the meta-analysis. Results The pooled prevalence of Good BPCR for all studies yielded an estimate of 58.7% (95% CI 43.9 to 72.7%). The I2 statistic was 98%, indicating statistically significant heterogeneity among the studies. The percentage of women with good birth preparedness and complication readiness increases with increasing year of publication, such that women tended to be more aware good birth preparedness and complication readiness in recent years. More than half of the women had knowledge of obstetric danger signs (52.0%, 95% CI 39.5 to 64.4%, 10 studies), arranged for transportation (59.5%, 95% CI 36.2 to 80.7, 11 studies) or saved money (63.4%, 95% CI 44.7 to 80.2%, 11 studies) as part of the BPCR. Conclusion Women in Nigeria are better prepared for birth preparedness and complication readiness in recent years. Therefore, interventions to promote more adequate birth preparedness and complication readiness among women is recommended.

Association of identification of facility and transportation for childbirth with institutional delivery in high priority districts of Uttar Pradesh, India

Background Timely and skilled care is key to reducing maternal and neonatal mortality. Birth preparedness involves preparation for safe childbirth during the antenatal period to reach the appropriate health facility for ensuring safe delivery. Hence, understanding the factors associated with birth preparedness and its significance for safe delivery is essential. This paper aims to assess the levels of birth preparedness, its determinants and association with institutional deliveries in High Priority Districts of Uttar Pradesh, India. Methods A community-based cross-sectional survey was conducted between June–October 2018 in the rural areas of 25 high priority districts of Uttar Pradesh, India. Simple random sampling was used to select 40 blocks among 294 blocks in 25 districts and 2646 primary sampling units within the selected blocks. The survey interviewed 9458 women who had a delivery 2 months prior to the survey. Descriptive statistics were included to characterize the study population. Multivariable logistic regression analyses were performed to identify the determinants of birth preparedness and to examine the association of birth preparedness with institutional delivery. Results Among the 9458 respondents, 61.8% had birth preparedness (both facility and transportation identified) and 79.1% delivered in a health facility. Women in other caste category (aOR = 1.24, CI 1.06–1.45) and those with 10 or more years of education (aOR = 1.68, CI 1.46–1.92) were more likely to have birth preparedness. Antenatal care (ANC) service uptake related factors like early registration for ANC (aOR = 1.14, CI 1.04–1.25) and three or more front line worker contacts (aOR = 1.61, CI 1.46–1.79) were also found to be significantly associated with birth preparedness. The adjusted multivariate model showed that those who identified both facility and transport were seven times more likely to undergo delivery in a health facility (aOR = 7.00, CI 6.07–8.08). Conclusion The results indicate the need for focussing on marginalized groups for improving birth preparedness. Increasing ANC registration in the first trimester of pregnancy, improving frontline worker contact, and optimum utilization of antenatal care check-ups for effective counselling on birth preparedness along with system level improvements could improve birth preparedness and consequently institutional delivery rates in Uttar Pradesh, India.

Testing the effectiveness of Community-Based Continuous Training Project on Improving the Domains of Birth Preparedness and Complication Readiness Intention Among Expecting Couples in Rural Settings of Rukwa Tanzania, A Controlled Quasi Experimental Study

Background: According to theory of planned behavior, the intention to engage into a behavior predicts the behavior to occur. The intention to engage into a behavior is influenced by three domains which are the attitude towards the behavior, the perceived subjective norms and the perceived behavior control. The study aimed at testing the effectiveness of a Community Based Continuous training (CBCT) intervention on improving the three domains of Birth Preparedness and Complication Readiness (BPCR) intention. Method: The quasi-experimental study design with control was done from June 2017 until March 2018. A multi-stage sampling technique was used to obtain 561 couples. Pre-test and end-line information were collected using semi-structured questionnaires developed using theory of planned behavior. The effectiveness of the intervention on improving domains of BPCR intention was assessed by using both independent t-test and pared t-test. Results: In comparison between groups at posttest assessment, there was a significant increase in mean scores only on perceived subjective norms in the intervention group if compared to the control group among pregnant women. Among male partners, none of the domain showed a significant difference between the intervention group and control group. In the comparison within groups, mean scores in all three domains had significant increase at posttest in both groups among male partners while among pregnant women the significant increase in the three domains were only among pregnant women in the intervention group. The predictor of change on attitudes and subjective norms mean scores were only the intervention β=0.065, p<0.05 and β=0.112, p=0.001 respectively. Predictors of change in perceived behavior control mean scores towards birth preparedness were level of education (secondary school, β=0.066, p<0.05), age at marriage (more than 24 years, β=0.069, p<0.05) and ethnic group (others, β=-0.067, p<0.05).Conclusion: The improvement brought by the intervention indicates that the intervention has the potential to significantly change the attitude and subjective norms domains of BPCR intention. The study recommends the CBCT intervention to be used in rural community to improve attitude and perceived subjective norms of BPCR intention.

MEN KNOWLEDGE/AWARENESS LEVEL ON BIRTH PREPAREDNESS AND COMPLICATION READINESS IN MAGARINI SUB COUNTY

Purpose: This study sought to find out the knowledge/awareness level of men on birth preparedness and complication readiness in Magarini Sub County. Methodology: A cross-sectional study sequential mixed methods design was used where a total of 464 men will be enrolled. Quantitative data was collected using semi structured questionnaires and interview guides were used to collect qualitative data. Quantitative data was coded, and analyzed by SPSS software. Qualitative data was analyzed using NVIVO software. Chi- square test was used to determine associations between categorical variables and Logistics regression was used to identify factors associated with birth preparedness and complication readiness. The associations between awareness and each independent variable were determined by odds ratio (OR) and 95% confidence interval (CI). Thematic content analysis was applied for qualitative data analysis. Findings: The result indicated that the odds of pregnancies resulting in a baby that was born alive were 47.306 times higher for more than two pregnancies as compared to one pregnancy(Odds=47.306,p=0.000). The odds of pregnancies resulting in a baby that was born alive were 16.25 times higher for one pregnancies as compared to no pregnancy(Odds=16.25,p=0.000). Unique contribution to theory, practice and policy Birth Preparedness and Complication Readiness (BPACR) should be endorsed as an essential component of safe motherhood programs to reduce delays for care-seeking for obstetric emergencies and this has been proven to positively impact on birth outcomes Keywords: knowledge/awareness level, birth preparedness, complication readiness, Magarini Sub County

To Assess the Effectiveness of Self-Instructional Module on Knowledge Regarding Obstetric Danger Signs, Birth Preparedness and Complications Readiness among the Primigravida Mothers

Background: Every pregnant woman faces the possibility of unforeseeable pregnancy problems, which can result in morbidity or fatality for herself or her infant. As a result, the concept of birth preparedness and complication readiness was developed, in which the family and community should plan ahead of time to protect the safety and well-being of the women and their new-borns throughout pregnancy, delivery, and after delivery. In the event of pregnancy and delivery problems, delivery intrapartum, and after postpartum, good plans and preparations will enhance usage of professional care and reduce delays in receiving care. Good plans and preparations will increase the usage of expert care and reduce the time it takes to seek care in the case of pregnancy and delivery complications [1]. Objectives: 1. To assess the existing knowledge on obstetric danger signs, birth preparedness and complications readiness among primigravida mothers. 2. To evaluate the effectiveness of self- instructional module on knowledge regarding obstetric dangers signs, birth preparedness and complications readiness among the primigravida mothers. 3. To find out the association between the knowledge regarding obstetric danger signs, birth preparedness and complications readiness with selected demographic variables. Materials and Methods: It is a quantitative research approach, in which one group pre-test post-test design will be used. Purposive sampling technique will be used to collect the data. Self-instructional module and structured questionnaire will be used to assess the effectiveness of self-instructional module on knowledge regarding obstetric danger signs, birth preparedness and complication readiness among the primigravida mothers.

Combined method of preparing the cervix uteri for labor in pregnant women with a lack of birth preparedness and a tendency to post-term pregnancy

Objective. Development of an effective method for preparing the cervix in pregnant women with a tendency to overmaturity against the background of a lack of biological readiness for childbirth, as well as reducing the time for preparing the soft birth canal for childbirth in order to conduct subsequent labor excitation. Material and methods. The patients were divided into 3 groups depending on the method of preparing the cervix for childbirth: in the 1st group (n = 50) only laminaria was used; in group 2 (n = 50), a Foley catheter was used in combination with mifepristone; in group 3 (n = 50), only mifepristone was used. Inclusion criteria: gestational period 41 weeks 41 weeks and 4 days inclusive, immature cervix (baseline score on the Bishop scale 0-2 points), singleton pregnancy, cephalic presentation, whole fetal bladder, vaginal cleanliness I-II, satisfactory fetal condition (normal type of curve according to CTG and the absence of fetal hemodynamic disorders according to Doppler data). Statistical processing of the obtained data was carried out using the STATISTICA 10.0 program. Research results. The patients of the three groups were comparable in age, gestational age, and did not differ in the parity of childbirth and body mass index. With the combined preparation of the cervix for childbirth with mifepristone and a Foley catheter, the dynamics of the assessment of the cervix on the Bishop scale is higher and achieved faster than when preparing for childbirth only with laminaria or only antigestagens. When combining mifepristone with a catheter Foley, it is possible to reduce the time interval from the onset of pre-induction to the development of labor in comparison with pre-induction of labor only with mifepristone or only with the help of laminaria, as well as reduce the frequency of caesarean section due to the lack of effect from induction of labor compared with pre-induction of labor only with mifepristone or only with the help of laminaria. The undoubted advantage of this combined method of preparing the cervix for childbirth is its effectiveness, low risk of uterine hyperstimulation, fetal distress syndrome, as well as the absence of a high risk of developing infectious complications. Conclusion. The combined method of preparing the body for childbirth with a tendency to post-term pregnancy is effective, safe and allows you to reduce the preparation time of the soft birth canal for childbirth against the background of a lack of biological readiness for childbirth with a tendency to post-term pregnancy.

Knowledge, Attitude and Perception of Planning Regarding Birth Preparedness and Complication Readiness at Tertiary Care Hospital Lucknow

Background: Globally, eight hundred women die every day due to pregnancy or child birth related complications. Aim: A descriptive study to assess the level of birth preparedness and complication readiness among antenatal women at a tertiary care hospital. Method: A descriptive cross sectional study was undertaken by using purposive sampling technique to assess the knowledge, attitude and planning of perception among antenatal women. Total 82 samples of antenatal women in third trimester were selected through purposive sampling from Tertiary care Hospital, Lucknow. Non experimental quantitative approach in which structured interview questionnaire was used for assessing the socio demographic data. Knowledge by interview method, attitude by likert scale and perception of planning by contingency questionnaire. Descriptive and Inferential statistics were used for the analysis of the tabulated data. Results: Out of total study samples (n=82) 34(41%) of antenatal women were well prepared regarding BPCR whereas 47(57%) are average prepared and 1(1%) are less prepared regarding BPCR. Conclusion: Birth preparedness and complication readiness (BPCR) is a key component of globally accepted safe motherhood programs, which helps ensure women to reach professional care when labor begins and to reduce delays that occur when mothers in labor experience obstetric complications. Keywords: Assess, level, antenatal women, BPCR