Birth Preparedness and Complication Readiness among Women with Pregnancy and Childbirth related Complications at Kenyatta National Teaching and Referral Hospital, Kenya.

Peter Kamwathi Ihomba,Tom Were,Jackim M Nyamari,Francis Ng'Ang'A Murima

doi:10.24248/eahrj.v4i1.618

Abstract

Background:In developing countries, particularly those in Sub-Saharan Africa, women and newborns continue to face increased risks of mortality and morbidity during the time of pregnancy, birth and postpartum. Preparing for childbirth and being ready for complications is a key strategy in reducing maternal mortality and morbidity as this would reduce delay in obtaining skilled maternal care especially during childbirth. This survey was evaluating birth preparedness and complication readiness (BPCR) among women seeking services at Kenyatta National Teaching and Referral Hospital.Methods:A cross-sectional hospital-based study was conducted among women admitted in the antenatal and postnatal ward. Data was collected using a standardised questionnaire. A respondent was considered to have satisfactory BPCR if she reported that she had identified the place of delivery, made prior financial arrangements and organised for means of transport to place of childbirth and/or for the time of obstetric emergencies ahead of childbirth.Results:The survey recruited 353 women aged between 15 and 44 years. Majority were married (n=288, 81.6%) and unemployed (n=232, 65.7%). Additionally, most of the participants were multiparous (n=345,97.7%) and had made at least 1 visit at the Antenatal Clinic during their current pregnancy (n=331, 93.8%). The proportion of women whose BPCR was rated as satisfactory was 56.7% (95% confidence interval, (CI) 49.7% - 63.6%). Factors associated with satisfactory BPCR included: being married (OR10.66, 95%CI5.21-21.83), having post-secondary education (OR 11.52, 95% CI 6.62-20.05), being in formal employment (OR 4.14, 95%CI2.51-6.82), gestation >28 weeks (OR=1.83,95%CI1.08-3.09), multiparity (OR=1.87,95%CI1.21-2.88), visiting Ante-natal Care Clinic (OR=9.31, 95% CI 2.70-32.09)and particularly visiting the clinic more than 2 times (OR=4.43, 95% CI 2.75-7.13).Conclusions:The study documented sub-optimal BPCR. This highlights the need to review the current strategies and approaches being utilised to promote BPCR.

Highlights

In developing countries, those in Sub-Saharan Africa, women and newborns continue to face increased risks of mortality and morbidity during the time of pregnancy, birth and postpartum
Socio Demographic Characteristics A total of 353 women seeking emergency obstetric services at Kenyatta National Teaching and Referral Hospital (KNH) were enrolled in the study
Investigations into the parity of the respondents revealed that majority were multiparous 345(97.7%)

Summary

Introduction

Those in Sub-Saharan Africa, women and newborns continue to face increased risks of mortality and morbidity during the time of pregnancy, birth and postpartum. Preparing for childbirth and being ready for complications is a key strategy in reducing maternal mortality and morbidity as this would reduce delay in obtaining skilled maternal care especially during childbirth. This survey was evaluating birth preparedness and complication readiness (BPCR) among women seeking services at Kenyatta National Teaching and Referral Hospital. Maternal deaths are thought to occur due to 3 main delays; delays in deciding to seek care, delays in reaching care, and delays in receiving care These delays have many causes including; logistic and financial concerns, unsupportive policies and gaps in services, as well as inadequate community and family awareness and knowledge about maternal and newborn health issues.[2] Delays in deciding to seek care may be caused by failure to recognise signs of complications, failure to perceive the severity of illness, cost considerations, previous negative experiences with the health care system, and transportation difficulties. Delays in receiving care may result from unprofessional attitudes of providers, shortages of supplies and basic equipment, lack of health care personnel, and poor skills of health care providers.[3]

Methods

Results

Conclusion