Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study

Abstract

BackgroundSelf-rated health status (SRH) can be used as a predictor of morbidity and mortality. Postpartum self-rated health has been used to estimate maternal morbidity and postpartum problems. Reproductive history factors are associated with poor self-rated health postpartum. This study investigated prevalence of self-reported health problems during first, second, and third trimesters of pregnancy, delivery, and postpartum. In addition, this study investigated SRH in Rwandan women up to 13 months from partus.MethodsThis population-based, cross-sectional study collected data in 2014 using structured interviews (N = 921). Univariable analysis was used to identify variables that were associated with poor self-rated health status (poor-SRH). Logistic regression analyses were performed to identify factors associated with poor-SRH at one day, one week, and one month postpartum and at the time of the interview.ResultsMean time between latest delivery and the time of interview was 7.1 months. Prevalence of anaemia, hypertension, diabetes mellitus during pregnancy, and severe bleeding during pregnancy and labour were 15.0, 4.9, 2.4, and 3.7 %, respectively. The prevalence of poor-SRH was 32.2 % at one day postpartum, 7.8 % at one month, and 11.7 % at time of the interview. Hypertension during pregnancy and significant postpartum haemorrhage were associated with poor-SRH at one day and one week postpartum. Severe bleeding during pregnancy and labour were associated with poor-SRH at one week and one month postpartum. Infection and anaemia during pregnancy were associated with poor-SRH at one month postpartum and at the time of interview. The Kaplan-Meier curves illustrate restitution of health for most women during the study period.ConclusionsThis population-based study reports a high prevalence of poor SRH status among Rwandan women in the early postpartum period. Identified factors associated with poor-SRH were severe bleeding, hypertension, infection, and anaemia during pregnancy and postpartum haemorrhage. These factors may be prevented or reduced by providing more frequent and specific attention during pregnancy and by providing timely measures that address complications during delivery, including adequate postpartum care.

Influencing Factors for Early Detection and Prevention of Postpartum Hemorrhage in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives.

“…Furthermore, the study of Semasaka et al, [14] on self-reported pregnancy-related health problems and self-rated health status in postpartum Rwandan women observed poor sexual and reproductive health care and recommended that particular attention be given to the determinants of poor quality care and to the early prevention of related complications. WHO [1] reports categories of main factors that prevent women from accessing or receiving care during pregnancy and childbirth to be related to poverty, distance to facilities, lack of information, inadequate and poor quality services, and cultural beliefs and practices.…”

Influencing Factors for Prevention of Postpartum Hemorrhage and Early Detection of Women at Risk in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives

“…Salient factors at different levels of service delivery have been found to be critical in shaping participants' experience for the implementation of obstetric hemorrhage initiative in Florida [13]. Furthermore, the study of Semasaka et al, [14] on self-reported pregnancy-related health problems and self-rated health status in postpartum Rwandan women observed poor sexual and reproductive health care and recommended that particular attention be given to the determinants of poor quality care and to the early prevention of related complications. WHO [1] reports categories of main factors that prevent women from accessing or receiving care during pregnancy and childbirth to be related to poverty, distance to facilities, lack of information, inadequate and poor quality services, and cultural beliefs and practices.…”

“…Cultural norms around childbearing and supernatural beliefs about PPH remain a challenge in some low-and-middle income countries to address PPH prevention [39]. In addition Semasaka et al, [14] report high prevalence of poor sexual and reproductive health among Rwandan women in the early postpartum period. Education programs designed to increase awareness of the causes of PPH and the potential dangers may improve understanding in these contexts [6,40].…”

Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives

“…Striking factors at different levels of service delivery have been found to be critical in shaping participants’ experience for the implementation of obstetric hemorrhage initiative in Florida [ 12 ]. Furthermore, the study of Semasaka et al [ 13 ] on self-reported pregnancy-related health problems and self-rated health status in postpartum Rwandan women observed poor sexual and reproductive health care and recommended that particular attention be given to determinants of poor quality care and to early prevention of related complications. Poverty, distance to facilities, lack of information, inadequate and poor quality services, and cultural beliefs and practices are reported by WHO [ 1 ] as different categories of main factors that prevent women from getting access to care during pregnancy and childbirth.…”