Complication Readiness Research Articles

Birth preparedness and complication readiness: Evaluating the "know-do" gap among women receiving antenatal care in Benin City, Nigeria.

Across several African countries, birth preparedness and complication readiness (BPACR) among pregnant women is poor. The practice of BPACR, though improving in recent years, is not commensurate with the knowledge available to pregnant women. Maternal health indices remain sub-optimal. This study evaluates the determinants of this "know-do' gap among women receiving antenatal care at a secondary health facility in Benin City, Nigeria. A cross-sectional study involving 427 pregnant women was conducted between October and December 2020 using a structured interviewer-administered questionnaire. The prevalence of knowledge and practice were described, and the determinants of BPACR practice evaluated using bivariable (chi-square) analysis and multivariable ordinal logistic regression with post-estimation predictive margins analysis. About 77% of respondents had good birth preparedness practice. Multivariable regression revealed that respondents with poor knowledge and moderate knowledge of components of BPACR had statistically significant lower odds (OR:0.05 (95% CI: 0.02-0.13) and 0.10 (95% CI: 0.03-0.30) times, respectively) for greater practice of BPACR when compared to those with good knowledge. Respondents with poor knowledge of danger signs had statistically significant lower odds (OR: 0.08 (95% CI: 0.03-0.26) for greater practice of BPACR when compared to those with good knowledge. But predictive margins analyses demonstrates that knowledge, though critical to practice, is insufficient to optimize practice. The optimum number of danger signs women need to know to improve practice may be between eight to ten. Beyond this number, practice may not change significantly. Other predictors of BPACR practice include income level, parity, gravidity, and residential settings. The number of antenatal clinic visits had no statistically significant correlation with BPACR practice. Interventions to facilitate practice at the community level may be helpful to improve outcomes and bridge the know-do gap with respect to BPACR within the study context.

Birth Preparedness and Complication Readiness among Women in Jugal Hospital, Harar, Ethiopia

Background: The majorities of maternal fatalities are avoidable and are generally blamed on patients delaying seeking care. Delays in deciding to seek treatment if a complication arises, delays in getting to care, and delays in obtaining care all have an impact on the availability and usage of obstetric services to avoid maternal mortality. So Birth preparedness and complication readiness is a crucial strategy for reducing maternal and newborn mortality. This study was aimed to assess the current status of birth preparedness and complication readiness in Harari regional state, Harar, Ethiopia from April 1st to 30th, 2023. Methods: An institution-based cross-sectional research was conducted at Jugal Hospital in Harar, Pregnant women who can hear and communicate and who were voluntary to participate were included. Systematic random sampling technique was used to select 233 pregnant women. The survey tool (questionnaire) used was developed by Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHIEGO). SPSS version 21 was used for analysis. Descriptive analysis was done and the results were presented in the form of narrative and table. Bivariable and multivariable logistic regression was done to identify factors associated with birth preparedness and complication readiness. All variables with p-value less than 0.25 in bivariable logistic regression model were entered to a multivariable logistic regression model for controlling possible confounding and odds ratios and their 95% CIs were computed. Result: Eighty-seven (37.83%), of the respondents mentioned at least two key obstetric danger signs during pregnancy, 92 (40.00%), of the respondents mentioned at least three key obstetric danger signs during childbirth and 66 (28.70%) of the respondents mentioned at least two key obstetric danger signs during postpartum period , 178 (77.39%), 199 (86.52%), 43 (18.70%), 67 (29.13%) and 7 (3.04%) of respondents indicated that they saved money, identified the place of delivery, identified skilled providers, identify means of transport and blood donors, respectively. Conclusion: This study revealed, age of the mother, Educational status, maternal occupation,. Residence, No. of pregnancy, Current ANC visit and History of stillbirth, were significantly associated with birth Preparedness and Complication readiness

A Study on Birth Preparedness and Complication Readiness among Women Attending Antenatal Clinics in a Rural Area of Hooghly District, West Bengal

ABSTRACT Background: Globally, more than 40% of pregnant women experience acute obstetric problems and a large burden of it is shared by India. Birth Preparedness and Complication Readiness (BPCR) strategy is used to addresses these problems by encouraging women and communities to effectively plan for births, deal with birth emergencies. Objective: This study was conducted to assess the status of birth preparedness and complication readiness and to find out the factors associated with inadequate BPCR among pregnant woman in a rural area of West Bengal. Methodology: Institution based, observational study with cross-sectional design was conducted from January 2019 to September 2020 among pregnant women, attending antenatal care clinics in Singur block, Hooghly district West Bengal. Sample size was 272. Participants were chosen by systematic random sampling. Response rate was 94.5% (257). Data were collected using a predesigned pretested schedule and analyzed using Microsoft Excel version 2016 and SPSS version 16.0. Results: Overall, 60.3% mothers had inadequate BPCR. 66.1% mothers had poor BPCR knowledge and 72.8% mothers had poor BPCR practice. In multivariable logistic regression model, the odds of maternal morbidity [AOR = 2.03 (1.14 –3.62), P value = 0.16], ≤4 No. of ANC visits [AOR = 10.96 (4.82–22.9), P value = 0.001], first trimester USG [OR = 12.53 (5.8–24.5), P value = 0.001] showed significance with inadequate BPCR. Conclusion: Glimpse of BPCR is seen in government programmes like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK). Yet a big void exists among Indian pregnant women’s knowledge and practice of BPCR. Thus, there is a need to include BPCR in health care system to improve outcomes for pregnant women.

“What you are asking is not what we are told to prepare’’: A communitybased study of Birth preparedness and complication readiness among postpartum women in a rural district, northern Tanzania

This study aimed to assess knowledge and practice of birth preparedness and complication readiness among women in a rural district, northern Tanzania.

Do pregnant women prepare and be ready for birth and its complications?

<b>Background:</b> Every pregnancy faces unpredictable complications and risks associated with the risk of maternal morbidity, mortality, and neonatal complications. The aim of the study is to determine birth preparedness and complication readiness (BPCR) among antenatal women and their determinants.<br /> <b>Methods:</b> The involved a total of 100 pregnant women at a public university hospital in Kelantan state, Malaysia. A self-administered questionnaire was used for data collection.<br /> <b>Results:</b> A total of 47.0% of participants were well prepared for their birth and its complications. There were no associations between being well prepared for birth and its complications with parity, gestational age, the total number of antenatal visits, or other sociodemographic data.<br /> <b>Conclusion:</b> BPCR among women were still low among women in Kelantan. Knowledge of the danger signs during pregnancy, labor, and the postnatal period among pregnant women is important to reduce maternal mortality.

Compliance toward key elements of kangaroo mother care and its predictors among postnatal mothers with preterm and/or low birth weight newborns in southern Ethiopia, 2021: A count analysis.

Although kangaroo mother care has been field-tested and found to be effective for preterm and/or low birth weight newborns at the health facility and community level, implementation and scale-up in low-income countries, including Ethiopia, have proven difficult. There was a dearth of evidence that shows compliance of mothers toward components of the kangaroo mother care. Hence, this study aimed at assessing the compliance of postnatal mothers toward World Health Organization-recommended elements of kangaroo mother care and the factors that influence it in southern Ethiopia, 2021. A hospital-based cross-sectional study was conducted among 257 mothers with preterm and low birth weight newborns from 1 July to 30 August 2021. A pretested, structured, interviewer-administered questionnaire and document review were used to collect data. The practice of kangaroo mother care was considered as a count variable. Analysis of variance and independent t-tests were used to examine the variation in the mean score of kangaroo mother care across covariates, and variables with a p value of 0.05 were eligible for the multivariable generalized linear regression model. The effect of each independent variable on the dependent variable was examined using multivariable generalized linear regression with a negative binomial log link. The mean (±standard deviation) practice score of kangaroo mother care items was 5.12 (±2.39), with 2 and 10 as the minimum and maximum item scores, respectively. Place of residence (adjusted odds ratio = 1.55; 95% confidence interval:1.33-2.29), mode of delivery (adjusted odds ratio = 1.37; 95% confidence interval: 1.11-2.21), birth preparedness and complication readiness plan (adjusted odds ratio = 1.63; 95% confidence interval:1.32-2.26), maternal knowledge of kangaroo mother care (adjusted odds ratio = 1.40; 95% confidence interval: 1.05-1.87), and place of delivery (adjusted odds ratio = 0.67; 95% confidence interval: 0.48-0.94) were identified as significant predictors of compliance toward key elements of kangaroo mother care. The overall practice of mothers toward key elements of kangaroo mother care was low in the study area. Health care providers who work in the maternal and child health service delivery points should pay special attention to women who come from rural areas and have had cesarean sections, by encouraging and guiding them to practice kangaroo mother care. Women should be counseled during antenatal care and after delivery to improve their knowledge of kangaroo mother care. Health workers in antenatal care clinics should place a strong emphasis on enhancing birth preparedness and complication readiness plans.

Community engagement for birth preparedness and complication readiness in the Community Level Interventions for Pre-eclampsia (CLIP) Trial in India: a mixed-method evaluation

ObjectiveTo describe the process of community engagement (CE) in northern Karnataka, India and its impact on pre-eclampsia knowledge, birth preparedness and complication readiness, pregnancy-related care seeking and maternal morbidity.DesignThis study...

Birth Preparedness and Complication Readiness Among Pregnant Women Attending an Urban Health Centre in Surat, India

Background: Birth preparedness is strategy to reduce MMR. It includes knowledge of key danger signs; identification of: birth place; birth attendant, fund, transport and compatible blood donor for emergency use. This study aims to explore birth preparedness in Surat and determine factors associated with it. Methods: Study conducted facility based cross-sectional study among 310 antenatal women at Urban Health Training Centre attached to Government Medical College, Surat, Gujarat. Predesigned, semi- structured, pretested questionnaire was used for data collection after informed written consent. Result: A total of 310 women participated in the study. Mean age of participants was 22.9+ 3.6 years. Almost one-third (30.3%) participants were illiterate. Almost six-tenth (61.9%) participants were involved in unskilled or semi-skilled work and two-fifth (38.1%) participants were homemakers. Majority of participants (96.7%) were registered in first trimester. Most known factor during pregnancy as danger sign was bleeding (81.9%). BPACR index was calculated as ∑Indicator/7 which was observed to be 62.3%. There was statistically significant association between awareness about health problems during pregnancy and type of family. Conclusion: Raising awareness regarding components of BPACR among antenatal women will help to reduce morbidity and mortality in antenatal women and achieve the sustainable development goal.

Knowledge, practice of and factors influencing birth preparedness and complication readiness among pregnant women attending antenatal clinic in a tertiary institution in South-Western Nigeria

Pregnancy and child birth are normal physiological processes expected to be uneventful with a fruitful outcome of a healthy mother and baby(ies). However, every pregnant woman faces the risk of sudden unpredictable complications that could lead to injury to herself, her infant or even death. Furthermore, no one can reliably predict pregnancy related complications and its outcome, hence the need to be birth prepared and complication ready. Therefore, this study assessed the knowledge, practice of and factors influencing birth preparedness and complication readiness among pregnant women attending antenatal clinic in a tertiary in a South-Western, Nigeria.
 The study adopted a cross-sectional descriptive research design utilizing quantitative approach. One hundred and forty-six (146) consenting pregnant women participated in this study. Data were manually collected and analyzed electronically with the use of SPSS computer software version 23.
 The results showed that more than half of the respondents 74 (50.7%) had overall poor knowledge of BPCR while majority of the respondents 88 (60.3%) had good overall practice of BPCR. The findings revealed that factors influencing practice of BPCR were inadequate prenatal education (82.2%), knowledge of key danger signs (80.8%), poverty and place of residents (80.1%), educational level (70.5%) and family size (60.3%). There was a significant relationship between the knowledge and practice of birth preparedness and complication readiness, with a p-value <0.05. 
 Base on the results we conclude that although the overall practice of BPCR is good while the overall knowledge is poor. There is a need to create an awareness and give adequate education on knowledge and practice of birth preparedness and complication readiness among pregnant women.

Birth preparedness and complication readiness among husbands and its association with skilled birth attendance in southern Ethiopia

IntroductionBirth preparedness and Complication Readiness (BPCR) promotes prompt use of skilled delivery and readiness for any complications to reduce delays in the provision of emergency care. Husband’s involvement in preparation for childbirth is one way to mitigate life-threatening delays in providing care during childbirth. The current study assessed the association of the husband’s involvement in birth preparedness and complication readiness with the use of skilled birth attendants.MethodA community-based cross-sectional study was conducted among 1,432 husbands. Study participants were selected from Arbaminch university health and demographic surveillance sites. Data were collected electronically using the Open Data Kit. The data were exported to STATA version 16 for analysis. Descriptive statistics were computed to describe the sociodemographic and reproductive variables of the study. The associations between birth preparedness and complication readiness practice and birth in the presence of a skilled birth attendant were assessed using multiple logistic regressions after adjusting for known confounders. Explanatory variables on bivariate logistic regression analysis were entered into multivariable logistic regression analysis, and a p-value of less than 0.05 was used to ascertain statistical significance.ResultsMean age of respondents was 33.7 (SD ± 6.2) years. Of all the respondents, 140 (10.3%) had made at least three preparations according to birth preparedness and complication readiness. After controlling for confounders through multivariable logistic regression, giving birth in the presence of a skilled birth attendant consistently increased with husbands involved in birth preparedness and complication readiness (AOR = 4.1, 95% CI: 2.5–6.9). Husbands whose wives had complications during previous pregnancy were 33% less likely to have skilled birth attendants (AOR = 0.67, 95% CI: 0.49–0.917). Moreover, husbands whose houses were near the health facilities were more likely to have skilled birth attendants for their wives (AOR = 3.93, 95% CI: 2.57–6.02).ConclusionHusband’s involvement in birth preparedness and complication readiness is strongly associated with using skilled birth attendants in Ethiopia. It is imperative that when designing husband’s involvement programs targeting birth preparedness and complication readiness, programs and strategies should focus on enhancing activities that are inclusive of husbands in birth preparedness and complication education.

Impact of Creating Awareness About Birth Preparedness and Complications Readiness Amongst Pregnant Women of Remote Communities with Extreme Poverty and Access Problems

Background: Although antenatal care sets in road to safety of mother and baby, birth affects pregnancy outcome most. Birth preparedness, complications readiness (BPCR) during pregnancy become essential, especially for rural women who have scarce health services, resources and access problems. Objectives: Community based study was carried out to know about impact of creating BPCR awareness to rural, tribal pregnant women. Material and methods: Study was conducted in 100 villages, randomly divided into 50 studies and 50 controls. Minimum 10 from each village, 15 to 39 years old, 1040 pregnant women, became study subjects. BPCR awareness was tried with maximum 5 sessions. Some women had only one session, because of inclusion from mid pregnancy, research assistant’s fixed visits, women’s availability. Ten randomly included women from each village in control set of villages, with no BPCR sessions, 1000 became study subjects. Pregnancy outcome was collected in study, as well as control villages. Results: Of 115 women who could have only one session, 45.2% found session useful, 16.5% of them had home births, 40.9% at Subcentre, 5.2% District hospital, 11.3% Referral hospital, 96.5% had live births, 3.5% stillbirths, 6.3% neonatal deaths occurred. Of 475 women who had 2-3 sessions, 77.1% found sessions useful, 3.6% had HBs, 42.3% at SC, 35.8% primary health centre, 30 (6.3%) DH, 12% RH, with 100% LBs, 1.1% NNDs. Of 450 women who had 4-5 sessions, 84.9% said sessions were very useful, 0.7% had HBs, 42.7% at SC, 38% PHC, 6.4% DH, 12.2% at RH, no SB, 1.6% NNDs. Of 1000 women who were not given BPCR awareness sessions, 40.4% had HB, 32.4% SC, 19.2% PHC, 2.8% DH, 5.2% RH, 92.7% had LBs, 7.3 SBs, 11.3% NNDs, no maternal death. Conclusion: BPCR awareness helped increase facility births, improved neonatal outcome, especially with more sessions.

Factors associated with institutional delivery among mothers who gave birth within 1 year prior to the study at Gilgelbelles town, Northwest Ethiopia: a mixed-methods study

ObjectivesThis study aimed to assess factors associated with institutional delivery among mothers who had delivered within 1 year prior to the study at Gilgelbelles town, Northwest, Ethiopia.DesignA community-based mixed-methods study...

Birth preparedness and complication readiness practice and associated factors among pregnant women in Central Ethiopia, 2021: A cross-sectional study.

BackgroundBirth preparedness and complication readiness (BP/CR) is an intervention designated by the World Health Organization (WHO) as an essential element of the antenatal (ANC) package with a concept of a global strategy to reduce maternal mortality. In Ethiopia, the proportion of pregnant women preparing for birth and related complications has remained low. Whereas, the need for additional study is indicated to add more evidence to the country’s efforts to end preventable maternal death.MethodsA facility-based cross-sectional study was conducted from March 01 to May 01, 2021. A systematic random sampling technique was applied to recruit 422 pregnant women. Bivariable and multivariable binary logistic regression was fitted to identify factors associated with BP/CR practice. Variables with a p-value ≤ 0.25 on the bivariable analysis were included in multivariable analysis. Adjusted odds ratios (AOR) with the respective 95% confidence interval (CI) and a p-value <0.05 was used to set statistically significant variables in the multivariable analysis.ResultsA total of 414 pregnant women have participated in the study. The overall BP/CR practice level was 44.9% (95% CI: 40.1, 49.7). Preconception care utilization (PCC) (AOR = 2.31; 95% CI:1.38–3.86), urban residents (AOR = 2.00; 95% CI:1.21–3.31), knowledge of BP/CR (AOR = 2.29; 95% CI:1.27–3.47), knowledge of danger signs during pregnancy (AOR = 2.05; 95% CI:1.21–3.47), knowledge of danger signs in newborns (AOR = 2.06; 95% CI:1.21–3.47), starting ANC visits in the 1st and 2nd trimester (AOR = 2.52; 95% CI:1.40–4.52), number of ANC visit ≥ three (AOR = 1.66; 95% CI;1.01–2.74), knowing Expected Date of Delivery (EDD) (AOR = 3.71; 95% CI:2.01–6.82), and joint decision-making on obstetric services (AOR = 3.51; 95% CI;1.99–6.20) were factors significantly associated with BP/CR practice.ConclusionBased on the WHO standard, this study revealed a low level of BP/CR practice among pregnant women, with only less than half of women adequately prepared for childbirth and its complications. Moreover, it has been shown that BP/CR practice is influenced by socio-economic, maternal knowledge, and health service-related factors. Therefore, improving the status of BP/CR practice by expanding awareness creation opportunities, strengthening PCC and early ANC initiation by improving pregnant women’s understanding, and promoting joint decision-making on obstetric services are recommended.

Improving the Quality of Maternity Care through the Introduction of Professional Midwives and Mentoring in Selected Sub-District Hospitals in Bangladesh: A Mixed Method Study Protocol.

Introduction: Bangladesh introduced professional midwives in 2018 to address gaps in sexual and reproductive health services, focusing on improved maternity care. Facility mentoring has been introduced in selected facilities within the government to enable midwives as they move into their new roles. Objectives: To describe a protocol (1) to determine if introducing international standard midwives in rural sub-district hospitals in Bangladesh, both with and without facility mentoring, improve the availability and quality of maternal and newborn health care compared to the facility without midwives; and (2) to explore the experiences of the midwives, and the maternity staff and managers that they joined, following their introduction. Methods: This will be a mixed-methods study to examine differences between selected hospitals grouped into three categories: without midwives (only nurses), with midwives, and both with midwives and mentorship. Hospital selection will be based on choosing those with the highest birth caseload. The quantitative component will consist of facility observations and clinical data extraction to assess their (hospital and midwives) readiness (birth preparedness and complication readiness) and clinical care to explore whether facilities with newly introduced midwives have improved availability and quality of care. We will use facility assessment tools to extract clinical data. In addition, we will use a structured open-ended interview guideline to conduct focus groups and in-depth interviews to understand the perceptions, attitudes, and experiences among maternity staff (e.g., nurses and paramedics) and health managers (e.g., facility manager, residential medical officer, consultants), as well as the midwives themselves toward the newly introduced midwives and the quality of care. We plan to use a fixed effect logistic regression to compare the relationship between variables in the three hospital types for each observed data point. For analyzing qualitative data, we will adopt content analysis and use NVivo to identify themes related to perceptions, attitudes, and experiences. Expected results: The introduction of professional midwives may improve the quality of maternal health care in rural settings. The addition of a mentoring program can support midwives in transitioning into their new roles and introduce improved care quality.

Knowledge of obstetric danger signs and its determinants among household heads of a rural community in North-Western Nigeria

Background: Birth preparedness and complication readiness remains one of the important strategies for reducing maternal mortality. One of its important components is knowledge of obstetric danger signs (KODS). The KODS is as important to men as it is to women, especially in African countries where majority of the household heads are men and are the major decision makers. Objective: The objective of the study was to determine the KODS among the household heads of Nasarawan Buhari, Nigeria. Materials and Methods: A cross-sectional community-based descriptive study was conducted among 104 household heads (or their representatives) of Nasarawan Buhari, Giwa Local Government Area Kaduna State, Nigeria, from April 15 to May 10, 2019. Data were collected using pretested semi-structured interviewer-administered questionnaires. Data were analyzed using IBM SPSS version 25 (2017). Results: Majority of the respondents were aged between 40 and 49 years, with a mean age of 40 ± 12.6 years. The overall KODS was poor (70.2%). After controlling for confounders, the only determinant of good KODS was the age of respondents. Household heads older than 30 years were more likely to have good KODS than those younger than 30 years (odds ratio 1.04, 1.001–1.07). Conclusion: The overall KODS among the respondents was poor, while the age of respondents was a determinant of having good KODS. The Authority of Giwa Local Government Area Council (LGC) of Kaduna State should design and implement a program aimed at educating the household heads in the LGC.

Birth Preparedness and Complication Readiness among Women Within Reproductive Age in Mukura Sub County in Ngora District Eastern Uganda

Ngora district had a total of 3,248 under-five deaths in 2015 (Reproductive maternal newborn and child health report (2015). Ngora Fredica hospital registered 5 maternal deaths on September 6 and 11 in November in 2016. In total 22 maternal deaths in 3 months, 5 deaths are from Nora sub-county with high number of women with morbidity such as foot drop, ill health, maternal exhaustion, and fistulas. The purpose of the study was to assess factors that influence birth preparedness and complications readiness among community women of child-bearing age (15-49 years). Bivariate analysis with an unadjusted odds ratio at a 95% confidence level was performed to determine the factors that were associated with birth preparedness and complication readiness among women within reproductive age. Age (15-19 years COR = 1.68, p-value 0.000), Education level (no formal education COR = 6.1, p-value 0.000), Occupation (housewife not working COR = 4.58, p-value 0.000), Marital status (Single mothers COR = 2.60, p-value 0.000), Number of children (more than 6 children COR = 2.95, p-value 0.000), Distance to the health facility (Not walkable COR = 5.29, p-value 0.000), Cost of transport to the health facility (Not affordable COR = 4.91, p-value 0.010), Perceptions COR = 6.14, p-value 0.000, Knowledge (lack of knowledge on dander signs of birth complications COR = 3.19, p-value 0.000, Practice (not attending ANC COR = 2.95, p-value 0.000) and Practice (delivering from home COR = 3.80, p-value 0.006). Keywords: Birth preparedness, Birth Complication readiness, Reproductive age.

Factors influencing birth preparedness and complication readiness among childbearing age women in Thatta district, Sindh.

Birth preparedness and complication readiness (BPCR) is a broad system to increase the practice of trained health provision at the time of childbirth and the key interventions to decrease mothers' and newborns' death. However, its status and influencing factors have not been well studied at different levels in the study area. The current study aimed to assess the BPCR status and explore its associated factors influencing BPCR among childbearing age women in Thatta, District of Sindh. This community-based cross-sectional study was conducted among 770 recently delivered mothers from October 2016 -September 2017, recruited using a multistage cluster sampling technique. A structured validated close-ended questionnaire measuring BPCR knowledge and practices was used for the interviews. The results were analyzed by means of the Chi-square test, and a binary logistic regression model was used to determine the factors influencing BPCR. The overall response rate was 94.6%, with a low BPCR status. Out of 770 participants, only 163 (21.2%) were well prepared, while 607 (78.8%) were not prepared for safe childbirth and its complications. A small proportion of women knew about the serious warning signs of pregnancy, labour, childbirth and the postpartum period (16.2%), (15.3%) and (22.7%) respectively. Antenatal care (ANC) checkup (P < 0.001), cost of ANC checkup (p = 0.016), place of birth (p = 0.014), awareness of serious warning signs during pregnancy (p = 0.001) and awareness of serious warning signs during the postpartum period (p < 0.001) were found to be significant predictors of BPCR. The proportion of women who were well prepared for birth and its complications was low. It is recommended to organize community-based education campaigns and improve the quality of MNCH services at every level to increase BPCR among women in Sindh.

Group Antenatal Care in Ghana: Protocol for a Cluster Randomized Controlled Trial.

BackgroundWhile group antenatal care (ANC) has been delivered and studied in high-income countries for over a decade, it has only recently been introduced as an alternative to individual care in sub-Saharan Africa. Although the experimental design of the studies from high-resource countries have been scientifically rigorous, findings cannot be generalized to low-resource countries with low literacy rates and high rates of maternal and newborn morbidity and mortality. The Group Antenatal Care Delivery Project (GRAND) is a collaboration between the University of Michigan in the United States and the Dodowa Health Research Centre in Ghana. GRAND is a 5-year, cluster randomized controlled trial (RCT). Our intervention—group ANC—consists of grouping women by similar gestational ages of pregnancy into small groups at the first ANC visit. They then meet with the same group and the same midwife at the recommended intervals for care.ObjectiveThis study aims to improve health literacy, increase birth preparedness and complication readiness, and optimize maternal and newborn outcomes among women attending ANC at seven rural health facilities in the Eastern Region of Ghana.MethodsQuantitative data will be collected at four time points using a secure web application for data collection and a database management tool. Data will be analyzed on an intention-to-treat basis to test the differences between the two arms: women randomized to group-based ANC and women randomized to routine individual ANC. We will conduct a process evaluation concurrently to identify and document patient, provider, and system barriers and facilitators to program implementation.ResultsThe study was funded in September 2018. Recruitment and enrollment of participants and data collection started in July 2019. In November 2021, we completed participant enrollment in the study (n=1761), and we completed data collection at the third trimester in May 2022 (n=1284). Data collection at the additional three time points is ongoing: 6 weeks postpartum, 6 months postpartum, and 1 year postpartum.ConclusionsThis study is significant and timely because it is among the first RCTs to be conducted to examine the effects of group ANC among low-literacy and nonliterate participants. Our findings have the potential to impact how clinical care is delivered to low-literacy populations, both globally and domestically, to improve maternal and newborn outcomes.Trial RegistrationClinicalTrials.gov NCT04033003; https://clinicaltrials.gov/ct2/show/NCT04033003International Registered Report Identifier (IRRID)DERR1-10.2196/40828

Birth Preparedness and Complication Readiness among Husbands Whose Wives were Delivered Within the Last 12 Months: A Cross-sectional Study

Birth Preparedness and Complication Readiness among Husbands Whose Wives were Delivered Within the Last 12 Months: A Cross-sectional Study

Birth preparedness and complication readiness practice among women attending antenatal care follow up in Yirgalem general hospital, southern Ethiopia.

In developing countries, maternal and newborn mortality is a major public health issue. Birth preparedness and complication readiness is a method to encourage pregnant women to seek professional birth attendants as soon as possible. The aim of this study was to evaluate practice and factors associated with birth preparedness and complication readiness among women attending antenatal care, southern Ethiopia, in 2019. From September 1st to September 30th, 2019, a facility-based cross-sectional study was conducted. 422 pregnant women were randomly selected and interviewed using a structured questionnaire. Epi-data version 3.1 was used to enter data, while SPSS version 21 was used to analyze it. To find factors associated with birth preparedness and complications readiness, researchers used multivariable logistic regression.From 422 study participants, 205(48.6%) (95% CI: 46.9%, 49.8%) have birth preparedness and complication readiness practice. Age of respondent ≥ 37 years (AOR = 4.2, 95% C.I = 1.23, 14.24) and between 25 to 30 (AOR = 2.35, 95% C.I = 1.1, 5.1); level of education College and above(AOR = 5.59, 95% C.I 2.8, 11.2) and secondary school (AOR = 9.5, 95% C.I 3.99-22); previous history of ANC follow up (AOR = 4.33, 95% C.I = 2.46, 7.61), birth outcome with live birth(AOR = 3.53, 95% C.I = 1.51, 8.25), and history of birth at health facility (AOR = 3.09, 95% C.I = 1.72, 5.56) where factors significantly associated with birth preparedness and complication readiness practice. Overall, there was low birth preparedness and complication readiness practices were observed in current study. Age of respondents, level of education, history of ANC follow up, and history of birth at a health facility were factors associated with birth preparedness and complication readiness practice. Governments with other stakeholders should work by focusing on antenatal care and institutional delivery by focusing on older age group mothers with who has no formal education.