ASSESSMENT OF BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG PREGNANT WOMEN IN BENIN CITY, EDO STATE

Abstract

BACKGROUND
Nigeria accounts for nearly 10% of the global estimates of maternal mortality. Lack of advance planning for use of skilled birth attendants for normal births and particularly inadequate preparation for rapid action in the event of obstetric complications are well documented factors contributing to delays in receiving skilled obstetric care. This study was carried out to assess birth preparedness and complication readiness and associated factors among pregnant women in Benin City, with a view to improve skilled attendance at birth and health facility deliveries.
METHODOLOGY: A descriptive cross sectional study design was utilized in this study involving the use of pretested quantitative and qualitative tools for data collection. A total of 252 pregnant women in their third trimester and their male partners/family members, 417 health care providers, 114 health care facilities participated in the study. In addition 10 key informants, 33 in-depth interview and 12 focus group discussion sessions were conducted. The pregnant women were reassessed immediately after delivery to ascertain their actual level of birth preparedness in relation to health facility delivery and skilled attendant at birth.
RESULTS
Two hundred and forty three (96.4%) of the pregnant women, 218(92.0%) of their spouse/male partners and 361(86.6%) of the health care providers had good knowledge of birth preparedness and complication readiness. One hundred and seventy two (89.1%) of the pregnant women reported health care providers as their main source of information. Two hundred and thirty eight (94.6%) of the pregnant women had positive attitude towards birth preparedness and complication readiness and 180(71.4%) pregnant women were very satisfied with regard to the perceived quality of services rendered by health care providers. In relation to practice of BPACR, 238(94.4%) of the pregnant women had registered for antenatal care, 234(98.3%) had identified a health facility, 233(92.5%) identified a skilled care provider, 165(65.5%) made transportation plans while 74(29.4%) had savings as emergency fund and 21(8.3%) had identified potential blood donor. In relation to place of delivery, 229(90.9%) pregnant women opted for health facility as their intended place of delivery, while 204(81.0%) respondents
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actually delivered in health facilities. One hundred and ninety seven (78.2%) of the pregnant women studied were well prepared for birth during pregnancy and 218 (94.4%) at delivery. In relation to practice of BPACR among pregnant women, awareness of BP (OR=0.34; p<0.01) and ANC registration (OR=0.02; p=0.02) were significant predictors for the intended and actual birth plan respectively. Also, registering for ANC (χ2=4.12, p =0.04), having available (emergency) funds (χ2=3.87, p<0.05) and planning for skilled attendant at birth (χ2=12.69, p<0.01) were significant factors identified to influence health facility deliveries.
The level of male involvement in antenatal was low 33(13.9%) and similarly for community involvement 17(6.7%).
Private owned health care facilities compared to public health care facilities were better prepared to render both basic essential obstetric care and comprehensive obstetric care (OR=0.11; p<0.01 and OR=0.08; p=0.01 respectively). In relation to knowledge of BPACR among HCPs, 361(86.6%) had good knowledge while 56(13.4%) fair knowledge. Awareness of BP (OR=2.33; p=0.02), training received on BP (OR= 0.21; p<0.01) and educational status of HCPs (OR =0.34; p=0.02) were significant predictors of good knowledge among HCPs.
CONCLUSION
This study showed that majority of pregnant women studied had good knowledge, positive attitude towards BPACR and well prepared for intended and actual birth plans. Antenatal Care (ANC) registration, having savings plans (emergency funds) and planning for skilled attendants at birth were significant determinants for health facility deliveries. The level of male and community involvement in BPACR was low. Knowledge of birth preparedness and complication readiness among health care providers was good. Majority of the health facilities studied were well prepared to render basic and comprehensive essential obstetric care with private health care facilities being better prepared based on availability of water source and staff for operation. There is need to promote health provider knowledge of this strategy through regular training and retraining programs on BPACR and intensified sensitization for better male and community involvement in care and support for pregnant women and the newborn.

ASSESSMENT OF BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG PREGNANT WOMEN IN BENIN CITY, EDO STATE