Background. Birth preparedness and complication readiness (BPACR) has been advocated as a strategy to overcome costly delays in decision-making to seek skilled attendance at delivery, which in turn contribute significantly to maternal mortality from obstetric causes. Objective. To assess the determinants of BPACR among pregnant women in a rural community in Edo State, Nigeria. Methods. A descriptive cross-sectional study was done in Anegbette, a rural community in Etsako Central Local Government Area of Edo State. A house-to-house survey was carried out to identify pregnant women and all eligible women in the study area were included in the study. Results. A total of 277 pregnant women participated in the study. The mean age (standard deviation) of respondents was 28.7 (5.8) years. Less than half (134, 48.4%) of the respondents were well prepared while 143 (51.6%) were poorly prepared. After adjustment for confounding effect using binary logistic regression analysis, educational level (odds ratio (OR) 0.653, 95% confidence interval (CI) 0.330 -0.956), occupation (OR 0.384, 95% CI 0.148 -0.990) and utilisation of antenatal care (OR 3.407, 95% CI 1.830 -5.074) were significant predictors of BPACR. Conclusion. BPACR was poor among women in the rural community. In order to improve maternal health among rural women in Nigeria, government and donor agency funding for safe motherhood programmes should focus on female empowerment and encourage community participation towards promotion of maternal health. Birth preparedness and complication readiness (BPACR) has been advocated as a strategy to overcome costly delays in decision-making to seek skilled attendance at delivery, which in turn contribute significantly to maternal mortality from obstetric causes.[1] BPACR entails identifying a skilled provider and a birth location, learning to recognise the danger signs that may indicate life-threatening complications for the mother and baby, saving money and arranging for transportation, identifying a blood donor, identifying the nearest emer gency obstetric services should pregnant women, their families and communities need to seek assistance in case of emergencies.[2] In addition, BPACR requires health providers and facilities to be prepared to attend births and treat complications. [2] BPACR among pregnant women is significantly influenced by their socioeconomic characteristics, among other personal factors. A study conducted among women attending antenatal care in south eastern Nigeria found that although 70.6% of women were aware of BPACR, knowledge of key danger signs in pregnancy was low; educational status was identified to be the best predictor of BPACR.[3] Similarly, having a higher education, upper socioeconomic status and being married were identified as factors associated with good BPACR among women receiving antenatal care in Benin City [4] and Ile-Ife, [5] Nigeria. A community-based survey in northern Nigeria among 5 083 rural women recruited from three states found that BPACR practices were generally poor, with...

Background Functionality of essential delivery services at primary health care (PHC) centres is crucial to achieving targeted improvements in maternal and neonatal outcomes in Nigeria. However, evidence suggests that PHC centres are often unable to adequately render basic emergency obstetric and neonatal care (BEmONC) services. This study assessed BEmONC availability and facility readiness at PHC centres in Edo State, Nigeria. Methods This facility-based cross-sectional survey was conducted in Edo State, Nigeria among 36 public primary health care centres selected by multistage sampling. The WHO service availability and readiness assessment tool was adapted to obtain data from PHC centres. BEmONC availability index was derived using 6 indicators (intravenous oxytotics, intravenous anticonvulsants, intravenous antibiotics, assisted deliveries, removal of retained products of conception and neonatal resuscitation). A composite readiness index was developed based on 26 indicators across five domains (trained staff, basic amenities, basic equipment, diagnostic tests and essential medicines). Indices were summarized as mean percentages and 95% confidence intervals. Results Among 36 facilities assessed, the mean BEmONC availability index score was 48.6% (CI = 41.7 - 55.5%) while the mean composite readiness index score was 58.9% (CI = 54.5 - 63.2%). Domain specific readiness indices showed marked variations with low mean scores for basic amenities (45.8%, CI = 38.4 - 55.3%) and trained staff (43.5%, CI = 33.1 - 53.9%), moderate score for basic equipment (53.5%, CI = 48.6 - 58.5%) and high scores for diagnostic tests (71.2%, CI = 60.5 - 82.1%) and essential medicines (80.1%, CI = 72.4 - 87.8%). Conclusions BEmONC availability and readiness at PHC centres in Edo State was suboptimal. Current efforts to improve services at PHC centres should strategically target availability of emergency obstetric functions, enhancing staff capacity and upgrading basic amenities. Key messages There are crucial gaps in the provision of BEmONC at primary health care level in Edo State, Nigeria that may negatively impact the quality of maternal and neonatal care. This study highlights the need for stakeholders to intensify PHC strengthening initiatives geared towards better pregnancy outcomes.