Level and determinants of birth preparedness and complication readiness among pregnant women: A cross sectional study in a rural area in Bangladesh

Abstract

BackgroundIncreasing the level of birth preparedness and complication readiness (BP/CR) is one of the key interventions to promote optimal utilization of skilled maternal health services. It is therefore essential to determine the women’s ability to recognize the danger signs and the level of BP/CR. This information can be used to design more effective health interventions.ObjectivesThis study was conducted to determine the knowledge in recognition of maternal complications, and the level and factors associated with BP/CR in rural Matlab, Bangladesh.MethodsA community-based cross-sectional survey was conducted from June- October 2015 on a randomly selected 2262 women who delivered live or stillbirth during the year 2014. A pretested and structured questionnaire was used for data collection. Descriptive and analytical statistical methods were used.ResultsThe proportion of study participants with “good knowledge”, measured by the ability to recognise three or more danger signs, in pregnancy and delivery were 26% and 23%, respectively. Out of four BP/CR components, about 15% women saved money, 12% women identified facility for delivery, 9.6% women planned to deliver by skilled birth attendant and 5.3% of women arranged transport. About 12% of women were “well prepared”, measured by planning of at least two components, for skilled childbirth and emergency obstetric complications. In the multivariable logistic regression analysis, asset index, antenatal care (ANC) visits and knowledge of danger signs during pregnancy and delivery were associated with BP/CR. The adjusted odds ratio (OR) of “well prepared” was 4.09 (95% confidence interval [CI]: 2.45–6.82) among women with an asset index of five (richest), compared with women in the asset index of one (poorest). The odds of “well prepared” was six times (OR 5.98, 95% CI: 3.85–9.28) higher for women with four or more ANC visits, compared to women with none or one ANC visit. In comparison to women with “poor knowledge” on maternal danger signs during pregnancy and delivery, the odds ratio of “well prepared” among women with good knowledge during pregnancy and in delivery were 1.95 (95% CI: 1.44–2.63) and 1.74 (95% CI: 1.28–2.36), respectively.ConclusionThe study revealed a low level of maternal knowledge of danger signs and BP/CR among pregnant women. Further, low socioeconomic status, fewer ANC visits and poor knowledge in recognition of dangers signs on maternal health were associated with low BP/CR. More emphasis should be placed on the quality of information offered to the pregnant women during the prenatal contact and women from low socio-economic gradient should be prioritized to optimize the impact of future BP/CR interventions.

Developing Targeted Client Communication Messages to Women in Bangladesh: A Qualitative Approach Based on Women’s and Family Members’ Perceptions and Knowledge of Antenatal Care

“…Poor understanding of complications, combined with the lack of contextual health education, might lead to less timely attendance at ANC. Similar to our ndings, another study in Matlab, Bangladesh, reported that only 26% of women had good knowledge of pregnancy complications [15]. Several studies have showed that ANC utilization is associated with women's knowledge about pregnancy complications [15,60,61].…”

“…Similar to our ndings, another study in Matlab, Bangladesh, reported that only 26% of women had good knowledge of pregnancy complications [15]. Several studies have showed that ANC utilization is associated with women's knowledge about pregnancy complications [15,60,61]. Women with poor knowledge of pregnancy complications are likely to also be unfamiliar with the consequences of the conditions.…”

“…Domiciliary community health workers from both wings provide health education on maternal and child health at the village level [29,30]. At the primary care level, maternal health services are provided at both Community Clinics (CC) and Union Health and Family Welfare Centres (UHFWC) [15]. The UHFWC cover a population of about 25,000, while CCs cover an average of 6,000 [29,30].…”

“…Maternal knowledge of complications is an essential precondition for routine ANC attendance for identi cation of early pregnancy-related complications, especially because most of these complications have no symptoms before severe illness develops. Studies from low-and middle-income countries, including Bangladesh, have reported that knowledge about pregnancy complications is low [12][13][14][15].…”

Maternal birth preparedness and complication readiness in the Greater Accra region of Ghana: a cross-sectional study of two urban health facilities

“…Levels of BP/CR vary across the literature and are generally low [9]. Socio-demographic characteristics, including age, parity and education as well as socio-economic factors, such as income, have been shown to influence BP/CR across different socio-cultural settings.…”