An Assessment of Birth Preparedness and Complication Readiness in Antenatal Women in Umuahia North Local Government Area, Abia State.

Abstract

Introduction: Maternal mortality is a global burden with more than 500.000 women dying each year due to pregnancy and child birth-related complications. Birthpreparedness and complication readiness is a comprehensive strategy to improve the use of skilled providers at birth. the key intervention to decrease maternal mortality. Several clonor agencies and the Federal Government of Nigeria have done a lot and adopted various policies includ ing birth-prepare dness and complication readiness to improve safe motherhood b ut all these have not translated to any significant reduction in maternal mortality rate. Some of these policies have also not been eva luated in Abia State. This study therefore aimed to assess the awareness of danger. signs of obstetric complications and to identify associated factors of pregnant women receiving antenatal care in public and private health care facilities in Umuahia North L.G.A. Methods : A descriptive cross sectional study involving both private and public health facilities. For the private health facilities. 4 private clinics were chosen by simple random. sampling from a frame 01' 45 private clinics and one maternity from a frame of 5 maternities, For the public heath-care facili ties. the Federa l Medical Center Urnuahia was purposively chosen. To obtain the required sample size of 430 respondents, a systematic random sampling was done both in the public and in the private health care facilities that had been selecied . Interviewer admi nistered questionnaires were used to obtain information that was analyzed using Epi into and SPSS statistical packages. Results: Of the 474 women. who were receiving antenatal care at the selected study sites. More than 98% of them attended antenatal care at least once. An average of 60.1 % of respondents had tertiary level or education and the proportion or those with tertiary education using public facilities were higher than those found in the private clinics and they belonged more to skilled/professional occupational group. Half of the women knew at least one obstetric danger sign the percentage of women who knew at least four danger signs during pregnancy was more than half and about 23.6% and 21.7% of them during delivery and after delivery respectively. An average of 54.2% had a plan for transportation (44.3% in private and 64. 1% in public), and 62.05%, (63 .3% in private and 60.8%% in public ) had a pl.,an to save 1110ney, an average of 54.2%%, (44.3% in private and 64.1% in public had made transport arrangements. Women with these plans were more likely to give birth with the assistance of a skilled provider. The study found ' out that husbands were significant decision makers on when and where to receive antenatal care and were also found to be the main sponsors for obstetric services (92.4%). The BP/CR index was 44 .1 5%. without inclusion of the community component and 33.1% when the community was included. Conclusions: The factors that affect BP/CR included the role of husbands in decision making process and financing of obstetric services. parity. poor percepti on of what to do in preparedness for childbirth and poor communication link with care providers, obvious non existence of community based support services for maternal health services was observed too. Only 0.3% of clients knew about community transport systems to aid safe motherhood and none of the respondents knew about any community blood donor system or financial support system. It is therefore recommended that the practice of focused antenatal care to improve BP/CR and utilization of skilled provider be improved. Better qualit y of counseling and education for primigravid, patients is also recommended as well as encouragement of greater male education conside ring their involvement in BP/CR (92.4%) sponsorship. 73.4% influence on decision of where to attend ANC a nd 75.4% influence on decision on when to start ANC thus the implication of their role in / BP/CR in safe motherhood programmes cannot be overemphasized.