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.

Are Pregnant Women in Rural Areas Aware of Birth Preparedness? Evidence from a Rural Maternity Hospital in South Karnataka

Background: Birth-preparedness and complication readiness (BPCR) is an evidence based strategy to reduce maternal and perinatal mortality. This study aims to assess awareness of BPCR and its determinants among pregnant women in a rural area of Ramanagara district, Karnataka, South India. Materials and Methods : A cross-sectional hospital-based study among pregnant women availing antenatal care, using the interview schedule from Johns Hopkins Program for International Education in Gynaecology and Obstetrics BPCR Tools and Indicators for Maternal and Newborn Health, with 41 items of BPCR awareness scored one for each correct response. Statistical analysis was performed using independent t-test, One-way ANOVA, Pearson’s correlation, and multi-logistic regression. Results The 331 pregnant women had low mean BPCR awareness score of 9.46 ± 3.61. Commonly mentioned obstetric danger signs were vaginal bleeding, severe weakness, and headache. BPCR awareness was significantly higher among multi-gravidae (P < 0.001), those with previous bad obstetric history (P = 0.002) or complications in the previous pregnancy (P = 0.031), those who registered their pregnancy early (P = 0.018) and those with four or more antenatal check-ups (P = 0.006). Multi-gravid mothers were twice more likely to have higher BPCR awareness than primigravidae. (Odds ratio = 2.41 [1.49–3.34], P < 0.001). Conclusions: Awareness of birth preparedness and obstetric danger signs among women in our study was found to be low. None of the women were aware regarding identifying a blood donor in advance in spite of vaginal bleeding being the most commonly cited danger sign. This study reveals an urgent need to address the lack of awareness of BPCR among rural women during routine antenatal visits or by community-level workers during home visits.

Health Care Seeking Behavior of Obstetric Danger Signs and its Associated Factors Among Pregnant and Delivered Mothers in Kewot District, North Shoa Zone, Amara Region, Ethiopia: A Cross-Sectional Study

Background: Many mothers died due to preventable causes in developing countries like Ethiopia. so, this study aims to assess the healthcare-seeking behavior of obstetric danger signs among pregnant and delivered mothers in 1 year before the study period in Kewot districts. Method: A community-based descriptive cross-sectional study design supplemented by qualitative technique was conducted from April 20 -April 30, 2019, in the Kewot district. Pregnant and delivered mothers were selected by systematic random sampling technique and interviewed with a response rate of 98.2%, Using purposive sampling 3 key-informants and 5 mothers were selected for in-depth interview of a qualitative study. Data were entered into Epi data version 3.1.1 and analyzed using SPSS version 21 and the logistic regressions model was applied to identify the associated factors. Results: A total of 363 participants were involved in the study. Among participants, 211(58.1 %) at (95% CI; CI: 53.7%-63.1%) were sought appropriate health care action. Women who have ANC follow up (AOR=1.735,95%CI:1.107-2.721), knowledgeable about danger sign, (AOR=2.430,95 % CI:1.360-4.342), the decision for own health care seeking (AOR=2.514,95% CI:1.130-5.501), and women who cannot able to judge graveness of condition (AOR=0.509,95% CI:0.302-0.859) were significantly associated with appropriate healthcare-seeking behavior.Conclusion: Having antenatal care follow up, knowledge about danger signs, inability to judge the graveness of conditions and inability to decide alone for own health care were factors that prevent appropriate health care seeking action. So, there should be health information dissemination about danger signs for every pregnant mother in the catchment area and during their visit to health institutions.

Prevalence and predictors of birth preparedness and complication readiness in the Kassena-Nankana district of Ghana: an analytical cross-sectional study

ObjectivesTo assess birth preparedness and complication readiness (BPACR) and associated factors among mothers who had given birth in the past 12 months prior to the study.DesignAn analytical cross-sectional study.SettingThe study was carried out in the rural areas of Kassena-Nankana district located in the Upper East Region of Ghana.ParticipantsThe study population comprised 600 postpartum women who had delivered within the last 12 months prior to the study.Primary outcome measureThe primary outcome measure was BPACR.ResultsThe prevalence of BPACR among recently delivered women was very low as less than 15% were able to mention at least three of the five basic components of birth preparedness/complication readiness that were fulfilled. After adjustment for confounding effect using multivariable logistic regression analysis, high educational level (adjusted OR (AOR)=3.40 (95% CI: 1.88 to 6.15)), better knowledge about obstetric danger signs during pregnancy (AOR=4.88 (95% CI: 2.68 to 8.90)), older women (≥35 years) (AOR=2.59 (95% CI: 1.11 to 6.02)), women of low household wealth index (AOR=4.64 (95% CI: 1.97 to 10.91)) and women who received lower content of antenatal care services (AOR=3.34 (95% CI: 1.69 to 6.60)) were significant predictors of BPACR.ConclusionThis study concludes that BPACR practices were low. High educational attainment of the woman, having adequate knowledge about obstetric danger signs during pregnancy, older women (≥35 years) and women of low household wealth index were significant predictors of BPACR. The predictors identified should be given high priority by health authorities in addressing low prevalence of BPACR.

Awareness of obstetric danger signs among pregnant women in the Democratic Republic of Congo: evidence from a nationwide cross-sectional study

Background Poor awareness of obstetric danger signs is a major contributing factor to delays in seeking obstetric care and hence to high maternal mortality and morbidity worldwide. We conducted the current study to assess the level of agreement on receipt of counseling on obstetric danger signs between direct observations of antenatal care (ANC) consultation and women’s recall in the exit interview. We also identified factors associated with pregnant women’s awareness of obstetric danger signs during pregnancy in the Democratic Republic of Congo (DRC) Methods We used data from the 2017–2018 DRC Service Provision Assessment survey. Agreement between the observation and woman’s recall was measured using Cohen’s kappa statistic and percent agreement. Multivariable Zero-Inflated Poisson (ZIP) regression was used to identify factors associated with the number of danger signs during pregnancy the woman knew. Results On average, women were aware of 1.5 ± 1.34 danger signs in pregnancy (range: 0 to 8). Agreement between observation and woman’s recall was 70.7%, with a positive agreement of 16.9% at the country level but ranging from 2.1% in Bandundu to 39.7% in Sud Kivu. Using multivariable ZIP analysis, the number of obstetric danger signs the women mentioned was significantly higher in multigravida women (Adj.IRR = 1.38; 95% CI: 1.23–1.55), in women attending a private facility (Adj.IRR = 1.15; 95% CI: 1.01–1.31), in women attending a subsequent ANC visit (Adj.IRR = 1.11; 95% CI: 1.01–1.21), and in women counseled on danger signs during the ANC visit (Adj.IRR = 1.19; 95% CI: 1.05–1.35). There was a regional variation in the awareness of danger signs, with the least mentioned signs in the middle and the most in the eastern provinces. Conclusions Our findings indicated poor agreement between directly observed counseling and women’s reports that counseling on obstetric danger signs occurred during the current ANC visit. We found that province of residence, provision of counseling on obstetric danger signs, facility ownership, gravidity and the number of ANC visits were predictors of the awareness of obstetric danger signs among pregnant women. These factors should be considered when developing strategies aim at improving women’s awareness about obstetric danger signs in the DRC