Abstract
BackgroundMaternal mortality is attributed to combination of contextual factors that cause delay in seeking care, leading to poor utilization of skilled health services. Community participation is one of the acknowledged strategies to improve health services utilization amongst the poor and rural communities. The study aimed at assessing the potentials of improving birth preparedness and complication readiness (BP/CR) using community-driven behavioural change intervention among pregnant women in rural Nigeria.MethodsA pre-post intervention study was conducted from June 2018 to October 2019 on 158 pregnant women selected through multi-stage sampling technique from 10 villages. Data on knowledge and practices of birth preparedness and utilization of facility health services were collected through interviewer-administered pre-tested structured questionnaire. Behavioural change intervention comprising of stakeholders’ engagement, health education, facilitation of emergency transport and fund saving system, and distribution of educational leaflets/posters were delivered by twenty trained volunteer community health workers. The intervention activities focused on sensitization on danger signs of pregnancy, birth preparedness and complication readiness practices and emergency response. Means, standard deviations, and percentages were calculated for descriptive statistics; and T-test and Chi square statistical tests were carried out to determine associations between variables. Statistical significance was set at p-value < 0.05.ResultsThe result showed that after the intervention, mean knowledge score of danger signs of pregnancy increased by 0.37 from baseline value of 3.94 (p < 0.001), and BP/CR elements increased by 0.27 from baseline value of 4.00 (p < 0.001). Mean score for BP/CR practices increased significantly by 0.22 for saving money. The proportion that had antenatal care (76.6%) and had facility delivery (60.0%) increased significantly by 8.2 and 8.3% respectively. Participation in Community-related BP/CR activities increased by 11.6% (p = 0.012).ConclusionWith the improvements recorded in the community-participatory intervention, birth preparedness and complication readiness should be promoted through community, household and male-partner inclusive strategies. Further evaluation will be required to ascertain the sustainability and impact of the programme.
Highlights
Maternal mortality is attributed to combination of contextual factors that cause delay in seeking care, leading to poor utilization of skilled health services
Participation in Communityrelated birth preparedness and complication readiness (BP/CR) activities increased by 11.6% (p = 0.012)
Birth preparedness and complication readiness is a process of planning for birth and anticipating actions to take in case of obstetric complications [6]
Summary
Maternal mortality is attributed to combination of contextual factors that cause delay in seeking care, leading to poor utilization of skilled health services. The direct causes which include hemorrhage, pregnancy-related hypertensive disorders, puerperal infections, obstructed labour, and septic abortions complications accounts for more than 70% of maternal deaths worldwide Indirect causes, such as pre-existing conditions including human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS), malaria, anemia, cardiovascular diseases and diabetes, contribute to more than 28% of maternal deaths [2, 4]. Poor knowledge of these danger signs and birth preparedness practices have been reported as contributory factors to maternal death [3, 4].
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