COMPARATIVE ASSESSMENT OF BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG WOMEN IN RURAL AND URBAN AREAS OF LAGOS STATE

COMPARATIVE ASSESSMENT OF BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG WOMEN IN RURAL AND URBAN AREAS OF LAGOS STATE

Abstract

Background:
The maternal mortality rate in sub-Saharan Africa remains the highest globally and Nigeria with just about 2% of the global population accounts for over 10% of the global maternal mortality. Birth preparedness and complication readiness (BPCR) which is the process of planning for birth and anticipating the actions needed in case of an emergency is a key determinant in the survival of a pregnant woman and her unborn child. In Nigeria, disparities often exist between rural and urban areas, with more maternal deaths occurring in the rural areas. This study thus set out to assess and compare the knowledge, attitude, practice and factors associated with birth preparedness and complication readiness among women in rural and urban areas in Lagos State.
Methodology:
The study was a comparative cross sectional study among 500 women of reproductive age in Surulere and Epe Local Government Areas (LGA) of Lagos State. A multi-staged sampling technique was used to select respondents for the study. A structured interviewer administered questionnaire adapted from the safe motherhood John Hopkins Program for International Education in Gynaecology and Obstetrics prototype questionnaire was used to collect data. Focus group discussions (FGD) were also used to collect data among women of reproductive age and their spouses in both Surulere and Epe LGAs. IBM SPSS Statistics Software package version 20 was used to analyse the questionnaires and a thematic framework analysis was used to analyse the FGDs
Results:
Majority of the respondents were married, of Yoruba ethnicity and had secondary level of education. More of the respondents in the rural area (93.2%) had good knowledge of birth preparedness and complication readiness compared with urban respondents (83.6%). A
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higher proportion of respondents in the urban area (26.8%) had positive attitude to birth preparedness and complication readiness compared with their peers in the rural area (24.8%). A higher proportion of urban respondents (49.6%) had good practice of BPCR compared with their rural peers (41.6%). Factors associated with practice of BPCR in rural and urban areas were good knowledge of BPCR, educational level, maternal monthly income and previous still birth. (p<0.05) However, after adjusting for confounders, significant predictors for practice of BPCR in the rural and urban areas were good knowledge of BPCR (AOR= 3.04; 95% CI: 1.61-5.75) and educational level (AOR=2.33 95% CI; 1.39-17.54). Maternal monthly income (p=0.518) and history of still birth (p=0.578) were not significant predictors of good practice of BPCR in the rural and urban areas. (p>0.05)
Conclusion:
Both rural and urban respondents had good knowledge of BPCR however knowledge of BPCR was significantly higher in the rural areas. Attitude towards BPCR was negative among both rural and urban respondents however positive attitude toward BPCR was higher in the urban area. Practice of BPCR was poor among both rural and urban respondents particularly in the area of identifying a blood donor however good practice of BPCR was higher in the urban area than in the rural area.
Recommendations:
It is important that urban populations should not be neglected in carrying out maternal health education interventions. Health care workers should educate pregnant women and their families on the need to identify potential blood donors and skilled health providers and encouraged to do so early in pregnancy. The government should train health workers in the area of service provision and introduce flexible payment schemes and community based health insurance for pregnant women to reduce out of pocket spending.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

COMPARATIVE ASSESSMENT OF BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG WOMEN IN RURAL AND URBAN AREAS OF LAGOS STATE

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