Complication Readiness Research Articles

Factors Influencing Birth Preparedness and Complication Readiness among Post-Natal Women in Selected Primary Health Centers in Ibadan, Nigeria

Background: Birth preparedness and complication readiness is a strategic intervention to achieve a reduction in the rate of maternal mortality. However, despite the importance and ease of use of this intervention, it has been observed that several factors have hindered the practice. Hence, the need to consider the knowledge, attitude, practice, and factors that influences Birth preparedness and Complication readiness among post-natal women. Method: This descriptive cross-sectional study used a multi-stage sampling technique to select 116 post-natal women in selected primary health centers in Ibadan North Local Government Area, Oyo state. An adapted structured questionnaire was used to assess the knowledge, attitude, practice and factors influencing the practice of birth preparedness and complication readiness. Statistical analysis was done using Statistical Package for the social science (SPSS) version 21.0 software. Descriptive data were presented as frequency and percentages while the chi-square test was used to test the hypotheses at P value < 0.05. Result: The majority of respondents were highly knowledgeable (86.2%). The respondents had a positive attitude towards birth preparedness and complication readiness (75%). The practice level was high among the respondents (71.6%). However, the factors that influenced practice were lack of adequate knowledge (X2=4.578, P =0.032), pre-mature delivery (X2=19.929, P=0.000) and environmental insecurities (X2=6.556, P=0.010). Conclusion: There is a relationship between factors (lack of adequate knowledge, premature delivery and environmental insecurities) and the practice of birth preparedness and complication readiness. Hence, measures should be employed to address the identified factors to improve the practice of birth preparedness and complication readiness.

Birth preparedness, complication readiness, and associated factors among pregnant women in South Wollo Zone, Northeast Ethiopia

Birth preparedness and complication readiness is a preparation strategy for normal birth and potential emergency situations, and is important for the safety and health of mothers and newborns during pregnancy, childbirth, and the postpartum period. This study aimed to assess the prevalence of birth preparedness and complication readiness and the associated factors among pregnant women. This was a community-based, cross-sectional study conducted among randomly selected 480 pregnant women from February to April of 2020. Bivariable logistic regression was performed to assess the association of each independent variable with the dependent variable. All variables with a P value of <.2 were entered into a multivariable logistic regression model to identify associated factors. Adjusted odds ratios with 95% confidence intervals were estimated to measure the strength of the association. Out of the 498 sampled pregnant women, 480 (96.4%) agreed to participate in the study; 104 were found to have satisfactory birth preparedness and complication readiness (21.7%; 95% confidence interval, 18.3-25.7). Having had an experience of obstetrical complications (adjusted odds ratio, 1.83; 95% confidence interval, 1.07-3.14), early starting time for antenatal care visits (adjusted odds ratio, 5.22; 95% confidence interval, 2.26-12.06), advice about birth preparedness (adjusted odds ratio, 2.99; 95% confidence interval, 1.21-7.39), and awareness about obstetrical danger signs during childbirth and the postpartum period (adjusted odds ratio, 2.23; 95% confidence interval, 1.33-3.74) were found to be significantly associated with birth preparedness and complication readiness. The prevalence of birth preparedness and complication readiness was low. Experience of obstetrical complications, starting time for antenatal care visits, advice about birth preparedness and complication readiness, and awareness of key danger signs during childbirth and the postpartum period were significantly associated with birth preparedness and complication readiness.

Birth Preparedness and Complication Readiness among Pregnant and Recently Delivered Women in Gandhinagar District, Gujarat, India: A Community-based Cross-sectional Study

Background: Birth Preparedness and Complication Readiness (BPCR) helps in improving the effective utilization of available maternal and newborn health care services through knowledge of danger sign, identifying birth place and attendant, means of transportation, managing fund for an emergency, birth companion and identification of blood donor. Aim: To find the association between socio-demographic characteristics and BPCR index indicators. Settings and Design: A cross-sectional study was conducted among the recently delivered and pregnant women in urban and rural areas of the Gandhinagar district of Gujarat. Methods and Material: Total 420 pregnant and recently delivered women from urban and rural areas were interviewed for study. A pretested semi-structured questionnaire was used to interview women at household setting. BPCR index is estimated by set of 7 quantifiable indicators and expressed in the percentage of women with specific characteristics. Results: Regarding ANC registration within 12th weeks of pregnancy and skilled birth attendant for delivery. Significant difference was observed with variable like APL/BPL status, education of women and their husband, parity and type of family. Conclusions: Hindu religion, APL economic status, higher education level, joint family, high parity and joint family were found important predictor of better BPCR practice.

Knowledge and Practice of Birth Preparedness and Complication Readiness among Healthcare Providers in Kaduna North Local Government Area of Kaduna State, Nigeria: A Qualitative Study

Background: Birth preparedness and complication readiness (BP&amp;CR) are strategies to reduce the three levels of delays contributing to high maternal mortality and morbidity in developing countries. Knowledge of BP and CR among healthcare providers, especially in Primary Health Care (PHC), is poor, and counselling on BP and CR during antenatal care visits is not routinely done in most healthcare facilities in Northern Nigeria. It is, therefore, imperative to assess the current in-depth knowledge and practice gap regarding BP and CR among health workers in PHCs. Aim: To assess Healthcare providers` knowledge and practice of focused antenatal care in PHC centres in Kaduna North Local Government (KNLG) Area of Kaduna State, Nigeria. Methods: A qualitative study was conducted using in-depth interviews. The participants were the officers-in-charge (the heads) of health facilities purposively selected from the four selected PHCs in the state. The data were collected with a tape recorder and note-taking from May to June 2017. The data resulting from the IDI were transcribed verbatim and subjected to using content analysis. Results: Two themes [poor knowledge of FANC and poor practice of BP and CR] emerged from the interviews. Conclusions: This study revealed poor knowledge, awareness and practice of BP and CR among healthcare providers. Therefore, healthcare providers should be trained and retrained on FANC and the concept of BP and CR for sustained improvement in maternal survival.

Magnitude and factors associated with birth preparedness and complication readiness among pregnant women in Wolaita Zone, Ethiopia.

To assess the magnitude and factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Humbo district, Wolaita Zone, Ethiopia. A community-based cross-sectional study was conducted from August 1 to 30, 2020. A total of 506 pregnant women were randomly selected and interviewed using a questionnaire. Data were entered using EpiData version 4.6.0, and analysis was made using SPSS version 24. An adjusted odds ratio (aOR) with a 95% confidence interval (CI) was calculated. The magnitude of BPCR in the Humbo district was 26.0%. The odds of being prepared for birth and its complications were higher among women who had a history of obstetric complications (aOR 2.77; 95% CI 1.18-6.52), participated in pregnant women's conferences (aOR 3.84; 95% CI 2.13-6.93), received advice on BPCR (aOR 2.39; 95% CI 1.36-4.22), and were knowledgeable on labor and childbirth danger signs (aOR 2.64; 95% CI 1.55-4.49). The magnitude of birth preparedness and complication readiness was low in the study area. The healthcare provider should encourage the women to participate in conferences and provide continuous counseling during their prenatal care visits.

Women’s Birth Preparedness and Complication Readiness in Nigeria: A Systematic Review and Meta-Analysis

INTRODUCTION:Globally, efforts are being made to reduce the menace of maternal death in order to achieve the sustainable development goal. Maternal death has been associated with inadequate Birth Preparedness and Complication Readiness (BPCR), especially in low- and middle-income countries. Therefore, this review assessed birth preparedness and complication readiness in Nigeria.METHODS:A systematic review and meta-analysis of published research articles on birth preparedness and complication readiness in Nigeria were done using PubMed, EMBASE, and MEDLINE databases. All published articles from inception to November 2018 were included in the review. A total of 8,913 published articles were identified from an electronic search, and a total of 4,440 studies were included in this review, while only 12 articles met the inclusion criteria and were included in the meta-analysis.RESULTS:The pooled prevalence of “good BPCR” for all studies yielded an estimate of 58.7% (95% CI 43.9%–72.7%). TheI 2statistic was 98%, indicating statistically significant heterogeneity among the studies. The percentage of women with good birth preparedness and complication readiness increases with the year of publication, such that women have tended to be more aware of good birth preparedness and complication readiness in recent years. More than half of the women had knowledge of obstetric danger signs (52.0%, 95% CI 39.5%–64.4%, 10 studies), arranged for transportation (59.5%, 95% CI 36.2%–80.7%, 11 studies), or saved money (63.4%, 95% CI 44.7%–80.2%, 11 studies) as part of the BPCR.PROSPERO REGISTRATION NUMBER:The study protocol was registered with PROSPERO number CRD42019123220.CONCLUSION:Women in Nigeria are better prepared for birth preparedness and complication readiness in recent years. Therefore, interventions to promote more adequate birth preparedness and complication readiness among women are recommended.

Perception of Primigravida Women on Birth Preparedness for a Safe Childbirth and Complication Readiness

Birth preparedness and complication readiness, a novel concept created by WHO. BPACR is a procedure for getting prepared for a normal delivery and anticipating actions that would be vital in any obstetric emergency, raising knowledge of danger signs, and teaching people to recognize and minimize the three delays.

Awareness of Obstetric and Delivery Complications Among Saudi Pregnant Women in Riyadh, Saudi Arabia.

The birth of a newborn is often celebrated with delight and excitement around the world. However, maternal mortality remains a great concern, and the majority of these deaths could have been prevented. This study aims to assess the awareness of obstetric and delivery complications among pregnant women in Riyadh, Saudi Arabia. A cross-sectional study was conducted among 385 pregnant women attending antenatal care clinics in Riyadh. The participants were interviewed using a pre-tested questionnaire that included sociodemographic and obstetric data, as well as 16 questions to measure awareness of danger signs during pregnancy, labor, and the postpartum period, and knowledge of Birth Preparedness and Complication Readiness (BPCR). Among the 385 pregnant women, only 45.5% were aware of associated complications during pregnancy, 18.4% during labor, and 30.6% during the postpartum period. Although 82% of the women had heard about BPCRpreviously, only 53% took action toward it. Certain factors, such as age, level of education, having a medical condition, and the number of antenatal care clinic visits, were associated with an increased level of awareness. The study highlights a lack of awareness regarding obstetric and delivery complications among Saudi pregnant women. Therefore, dedicated education by a healthcare provider during prenatal visits is recommended to increase knowledge and avoid future obstetric complications.

Institutional delivery service utilization and associated factors in fragile and conflict-affected situations in Sekota town, Northern Ethiopia, 2022: A community-based cross-sectional study

BackgroundConflict-affected areas are considered to contribute a substantial proportion of worldwide maternal deaths. However, research on maternal health care in conflict-affected countries is very limited. In the absence of recent data, it is impossible to monitor progress made in mitigating the effect of conflict on maternal survival. As a result, this study targeted to assess institutional delivery services usage and influencing factors in a fragile and conflict-affected situation in Sekota town, Northern Ethiopia. MethodsA community-based cross-sectional study was employed among 420 mothers in Sekota town, Northern Ethiopia from July 15th to 30th, 2022. The desired sample size was determined using a single population proportion formula. The data were collected by using interviewer administered structured questionnaire; entered via EpiData version 4.6 and analyzed using SPSS version 25 software. To identify the associated factors, a bivariable and multivariable logistic regression model was applied. The level of significance was declared at a p-value of <0.05. An adjusted odds ratio with a 95% confidence interval was considered to see the strength of the association between dependent and independent variables. ResultsOf the total respondent, 202 (48.1%), 95% CI: (43.0%, 53.0%) mothers utilized institutional delivery service. The use of institutional delivery services was associated with the maternal educational level of secondary school and above (AOR = 2.06, 95% CI: 1.08–3.93), antenatal care during the most recent pregnancy (AOR = 5.24, 95% CI: 3.01–9.11), being informed on birth preparedness and complication readiness (AOR = 1.93, 95% CI: 1.23–3.02) and displacement of the respondents from their usual place of residence due to conflict (AOR = 0.41, 95% CI: 0.21–0.68). ConclusionInstitutional delivery service utilization was very low in the study setting. Healthcare for women in conflict-prone areas requires critical attention and should be given priority during the conflict. More prospective research is needed to fully understand and reduce the impact of conflict on maternal and neonatal health care.

Role of male partners in birth preparedness and complication readiness: A qualitative study.

Background In familial and societal matters, men are the decision-makers and economic resource providers in many patriarchal societies. It is important to assess the involvement of men in birth preparedness and complication readiness (BPCR), as men act as gatekeepers to women's health. We examined the role, motivators and barriers for participation of male partners of pregnant women in BPCR. Methods This qualitative study was based on the grounded theory approach. Data were collected through 29 in-depth interviews conducted among husbands (n=8), mothers (n=8), mothers-in-law (n=8), health professionals (n=5) and focus group discussions (FGDs) with pregnant women (FGD, n=3). Interviews and FGDs were transcribed; themes and sub-themes were generated and conclusions were drawn by triangulation of the data. Results Men were found to have a major role in BPCR. They supported their pregnant wives by maintaining their health, providing financial support and helping them in the decision-making process regarding treatment. They also provided complication readiness support by arranging transportation and facilitating the process of hospital admission. Conclusions Our study emphasizes how changes have occurred in the attitudes and practices over generations regarding men's role in BPCR and their participation during delivery. However, there is a long way to go for which transference of knowledge and cultural transformation have become necessities.

Husband participation in birth preparedness and complication readiness and its predictors among men whose wife was admitted for an obstetric referral at South Gondar zone: A multicenter cross-sectional study

BackgroundHusbands' participation in maternal health care, as seen by an appropriate birth plan and readiness for complications, reduces maternal death by avoiding delays in recognizing danger signs, reaching a site of care, and seeking aid. As a result, this study aimed to determine the husband's participation in birth preparation and complication readiness, as well as its predictors, among men whose wives were referred to obstetric referral in the South Gondar Zone of North West Ethiopia. MethodsA hospital-based cross-sectional study was conducted among husbands whose wives were admitted with obstetric referrals in the selected hospitals from February to March 2021. A total of 393 individuals were chosen proportionally from the selected hospitals using a systematic random sampling technique. An interviewer-administered structured questionnaire was used to collect data, which was then entered into Epi Data Version 3.1 and exported to Stata version 14 for analysis. To find predictors of the outcome variable, a binary logistic regression model was used. The final model's results were expressed as adjusted odds ratios, 95% confidence intervals, and P-values. ResultThe magnitude of husband participation in birth preparedness and complication readiness among obstetric referrals was 282 (71.8%). Planned pregnancy [AOR, 95% CI: 2.78 (1.68–4.62)], discussion with their wife [AOR, 95% CI: 2.85 (1.72–4.71)], and good knowledge of danger signs during pregnancy, delivery, and postpartum [AOR, 95%CI:2.71 (1.67–4.42)] were significantly associated with husband participation as compared to its counterparts. Conclusion and RecommendationThe husband's participation in birth preparedness and complication readiness for obstetric referrals in the South Gondar zone were reasonably good. For good husband participation in birth preparedness and complication readiness, knowledge of danger signs, pregnancy planning status, and discussion with wife about pregnancy were responsible. Healthcare providers should support mothers in discussing the danger signs of pregnancy, birth preparedness, and complication readiness with their husbands during ANC visits.

Receiving antenatal care components and associated factors in Northwestern Tanzania.

Tanzania had an estimated 5.400 maternal deaths in 2020. Suboptimal quality of antenatal care (ANC) presents a major challenge. It is not known what precisely the uptake of the various ANC components is, such as counseling on birth preparedness and complication readiness, preventive measures and screening tests. We assessed the level of receiving the various ANC components and associated factors in order to identify opportunities to improve ANC. A cross-sectional household survey using a structured questionnaire through face-to-face interviews, was conducted in April 2016 in Mara and Kagera regions, Tanzania, applying a two-stage, stratified-cluster sampling design. The analysis included 1,162 women aged 15-49 years who attended ANC during their last pregnancy and had given birth not longer than two years prior to the survey. To account for inter- and intra-cluster variations, we used mixed-effect logistic regression to examine factors associated with receiving essential ANC components: counseling around birth preparedness and complication readiness (with presumed effects on knowledge about danger signs) and preventive measures. About In 878 (76.1%) women preparedness for birth and its complications was observed to exist. Overall counseling was low where 902 (77.6%) women received adequate counseling. Overall knowledge of danger signs was low in 467 women (40.2%). Uptake of preventive measures was low, with presumptive malaria treatment in 828 (71.3%) and treatment of intestinal worms in 519 (44.7%) women. Screening test levels varied for HIV in 1,057 (91.2%), any blood pressure measurement in 803 (70.4%), syphilis in 367 (32.2%) and tuberculosis in 186 (16.3%) women. After adjusting for age, wealth and parity, the likelihood of receiving adequate counseling on essential topics was less in women without education versus primary education (aOR 0.64; 95% CI 0.42-0.96) and in women who had <4 ANC visits versus ≥4 visits (aOR 0.57; 95% CI 0.40-0.81). Receiving care in privacy or not (aOR 2.01; 95% CI 1.30-3.12) and having secondary education as compared to primary education (aOR 1.92; 95% CI 1.10-3.70) were associated with receiving adequate counseling. Odds of receiving adequate care in at least one ANC visit were lower in women with joint decision making on major purchases versus decision making by male partner or other family members alone (aOR 0.44; 95% CI 0.24-0.78), similar to being less knowledgeable on danger signs (aOR 0.70; 95% CI 0.51-0.96). Overall uptake of various essential ANC components was low. Frequent ANC visits and ensuring privacy are all essential to improve the uptake of ANC.

Barriers to birth preparedness and complication readiness among pregnant women in rural Ethiopia: using a mixed study design, 2020

ObjectiveTo assess birth preparedness and complication readiness (BPCR) and associated factors among pregnant women in Bachoo District, Oromia, Ethiopia.DesignA mixed cross-sectional study design was employed to conduct this study.SettingA community-based...

Birth Preparedness and Complication Readiness among Pregnant Women in Rural Area of District Sonipat, Haryana, India: A Cross Sectional Community Based Study

Introduction: Birth Preparedness and Complication Readiness (BPCR) is an important intervention included by WHO as essential elements of antenatal care package. It is often delivered to pregnant women through their active participation by health care provider during antenatal care or initiated/followed up through visits to the homes of pregnant women by community health workers. Objectives: To determine the knowledge and practice regarding BPCR and to identify factors associated with it among rural pregnant women. Method: Cross-sectional study was conducted in rural field practice area of Community Medicine Department of a medical teaching institutes. A total of 210 pregnant women who were in the second and third trimesters of pregnancy were selected by simple random sampling and interviewed for data collection. Results: Mean age of study subjects was 24.14 + 3.88 years.The highest number of women was in the age group of 20-29 years (84.8%). More than half (57.6%) mothers had observed at least two or more components of BPCR. Maximum number of females had identified facility for delivery (63.8%) followed by transportation (60.9%). Identification of potential blood donor by mothers was low (14.3%). Bleeding was most commonly identified danger symptom in all three phases of child bearing. Knowledge regarding danger signs was significantly associated with birth preparedness. Conclusion: In the present study, practice of all components of BPCR by mothers was very low. Bleeding was the most commonly identified danger symptom during all three phases i.e., pregnancy, child birth and after birth.Knowledge regarding other danger signs was highly inadequate.

The uptake of WHO-recommended birth preparedness and complication readiness messages during pregnancy and its determinants among Ethiopian women: A multilevel mixed-effect analyses of 2016 demographic health survey.

Birth preparedness and complication readiness (BPCR) is a package of interventions recommended by the World Health Organization to improve maternal and newborn health and it is provided and implemented through a focused antenatal care program. This study aimed at assessing the uptake of birth preparedness and complication readiness messages, and compliance with each key message, among Ethiopian women during their recent pregnancies using the 2016 demographic health survey report. The data for this study was taken from the Ethiopian Demographic and Health Survey, which was conducted from January to June 2016 and covered all administrative regions. STATA version 16 was used to analyze a total of 4,712 (with a weighted frequency of 4,771.49) women. A multilevel mixed-effects logistic, and multilevel mixed-effect negative binomial regressions were fitted, respectively. Adjusted odds ratio (AOR) and Incidence rate ratio (IRR) with their corresponding 95% confidence interval (CI) were used to report significant determinants. More than half, 56.02% [95% CI: 54.58, 57.41] of women received at least one birth preparedness and complication readiness message. Being in the richest wealth quintiles (AOR = 2.33; 95% CI: 1.43, 3.73), having two birth/s in the last five years (AOR = 1.54; 95% CI: 1.13, 2.10), receiving four or more antenatal visits(AOR = 3.33; 95% CI: 2.49, 4.45), and reading a newspaper at least once a week (AOR = 1.27; 95% CI: 1.07, 1.65) were the individual‑level factors, whereas regions and residence(AOR = 1.54; 95% CI: 1.11, 1.96) were the community-level factors associated with the uptake of at least one BPCR message. On the other hand, receiving four or more antenatal visits (IRR = 2.78; 95% CI: 2.09, 3.71), getting permission to go to a health facility (IRR = 1.29; 95% CI: 1.028, 1.38), and not covered by health insurance schemes (IRR = 0.76; 95% CI: 0.68, 0.95) were identified as significant predictors of receiving key birth preparedness and complication readiness messages. The overall uptake of the WHO-recommended birth readiness and complication readiness message and compliance with each message in Ethiopia was found to be low. Managers and healthcare providers in the health sector must work to increase the number of antenatal visits. Policymakers should prioritize the implementation of activities and interventions that increase women's autonomy in decision-making, job opportunity, and economic capability to enhance their health-seeking behavior. The local administrative bodies should also work to enhance household enrollment in health insurance schemes.

Birth Preparedness and Complication Readiness Among Pregnant Women Attending Primary Health Care Centers in Erbil City

Background and Objectives: Birth preparedness and complication readiness (BP/CR) is a plan that helps women to consider all obtainable maternal health care services. The aim of this study was to assess the level of knowledge on key danger signs and components of BP/CR among pregnant women within 3rd trimester who attending primary health care centers in Erbil city.Methods: A descriptive study was conducted on 300 pregnant women, during the period mid-March 2019 to the end of July 2019 in five primary health care centers in Erbil city. Data gathered through interview with study sample and using structured questionnaires and purposive sampling technique used to selected samples. Data were analyzed by using the social package of statistical science (SPSS version 23).Results: Pregnant women were between the ages of 15 and 46 years, about 8% of the women aged less than 20 years, and 12.3% aged ≥ 35 years. About (93.7%)of the women thinks that planning for the place of delivery is important while only 1.3% thinks that it is important to identify skilled attendant. Also high knowledge about birth preparedness was associated significantly (p = 0.041) with age and the distance to the health care facility (p = 0.003) but there are not significant association with other socio-demographic factors.Conclusion: Large proportion of pregnant women had good knowledge about some of key danger signs. Generally, majority of the respondents had increased awareness on most of components of BP/CR.

Low knowledge of newborn danger signs among pregnant women in Papua New Guinea and implications for health seeking behaviour in early infancy – findings from a longitudinal study

BackgroundGlobally, 2.5 million babies die in the first 28 days of life each year with most of these deaths occurring in low- and middle-income countries. Early recognition of newborn danger signs is important in prompting timely care seeking behaviour. Little is known about women’s knowledge of newborn danger signs in Papua New Guinea. This study aims to assess this knowledge gap among a cohort of women in East New Britain Province.MethodsThis study assessed knowledge of newborn danger signs (as defined by the World Health Organization) at three time points from a prospective cohort study of women in East New Britain Province, factors associated with knowledge of danger signs after childbirth were assessed using logistic regression. This study includes quantitative and qualitative interview data from 699 pregnant women enrolled at their first antenatal clinic visit, followed up after childbirth (n = 638) and again at one-month post-partum (n = 599).ResultsKnowledge of newborn danger signs was very low. Among the 638 women, only 9.4% knew three newborn danger signs after childbirth and only one knew all four essential danger signs defined by Johns Hopkins University ‘Birth Preparedness and Complication Readiness’ Index. Higher knowledge scores were associated with higher gravidity, income level, partner involvement in antenatal care, and education.ConclusionLow levels of knowledge of newborn danger signs among pregnant women are a potential obstacle to timely care-seeking in rural Papua New Guinea. Antenatal and postnatal education, and policies that support enhanced education and decision-making powers for women and their families, are urgently needed.

Incidence and predictors of puerperal sepsis among postpartum women at Debre Markos comprehensive specialized hospital, northwest Ethiopia: A prospective cohort study.

Puerperal sepsis is one of the leading causes of maternal mortality, particularly in low and middle-income countries where most maternal deaths occur. Women with puerperal sepsis are prone to long-term disabilities, such as chronic pelvic pain, blocked fallopian tubes, and secondary infertility. Besides this, puerperal sepsis has received less attention. For this reason, this study aimed to determine the incidence of puerperal sepsis and its predictors among postpartum women at Debre Markos Comprehensive Specialized Hospital. A prospective cohort study was conducted among 330 postpartum women from September 2020 to 2021. A pre-tested interviewer-administered questionnaire with a data extraction checklist was used to collect the data. Data were entered into Epi data 4.2 and analyzed using STATA 14.0. The incidence rate of puerperal sepsis was calculated, and a Kaplan-Meier survival curve was used to estimate the survival probability of developing puerperal sepsis. The cox-proportional hazards regression model was fitted to identify predictors of puerperal sepsis. The study participants were followed for a total of 1685.3 person-week observations. The incidence rate of puerperal sepsis was 14.24 per 1,000 person-weeks. However, the overall incidence of puerperal sepsis was 7.27%. Not attending formal education [AHR: 3.55, 95% CI: (1.09-11.58)], a cesarean delivery [AHR: 4.50; 95% CI: (1.79-11.30)], premature rupture of the membranes [AHR: 3.25; 95% CI: (1.08-9.79)], complicated pregnancy [AHR: 4.80; 95% CI: (1.85-12.43)], being referred [AHR: 2.90; 95% CI: (1.10-7.65)], and not having birth preparedness and complication readiness plan [AHR: 2.95; 95% CI: (1.08-10.50)] were statistically significant predictors of puerperal sepsis. The incidence of puerperal sepsis was 7.27%. Not attending formal education, cesarean delivery, premature rupture of membranes, complicated pregnancy, referral status, and absence of birth preparedness and complication readiness plan were predictors associated with the incidence of puerperal sepsis.

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