This study, “ASSESSING KNOWLEDGE, PRACTICE AND FACTORS INFLUENCING BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG COUPLES” contains concise information that will serve as a framework or guide for your project work. The project study is well-researched for academic purposes and are usually provided in complete chapters with adequate References. Keywords: ASSESSING KNOWLEDGE, PRACTICE AND FACTORS INFLUENCING BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG COUPLES
Abstract This study was carried out to assess knowledge, practice and factors influencing birth preparedness and complication readiness among couples in selected rural communities in Oji River. The objectives of the study were to determine knowledge of birth preparedness and complication readiness among couples in the communities studied, couple’s practice of birth preparedness and complication readiness, identify factors that hinder couples practices of birth preparedness and complication readiness and establish the relationship between couple’s socio-economic status and their practice of birth preparedness and complication readiness. A cross-sectional descriptive survey research design was used for the study in selected seven communities of Oji River L.G.A. Descriptive and inferential statistics were used to analyse data at 0.05 level of significance. Major findings of the study revealed that 307(78.7%) couples had good knowledge while 25(6.4%) showed poor knowledge. The danger signs during pregnancy were well understood by more than 60% of the study population which includes prolonged labour (63%) and heavy vaginal bleeding (70.3%). Only 76 respondents (19.4%) of the study population engaged in good birth preparedness and complication readiness practices. Antenatal care attendance was poor with only 104 (26.7%) attending. Twenty three percent (88) of the couples made plans to deliver at a specific health facility while 274(70%) arranged for a birth companion. Major factors that hindered practice were financial constraint, lack of transport at night and premature delivery. Although most of the couples had good knowledge but this did not translate into practice. There is need to address these limiting factors, especially transportation for better pregnancy outcome in emergencies. The study recommends a slight shift of focus by government from hospital based to community based in maternal and child health projects for better rural coverage. CHAPTER ONE INTRODUCTION 1.1 Background to the study It is true that birth of baby precedes celebration but it equally poses source of concern as pregnancy and childbirth is sometimes a perilous journey especially in the developing countries, where the risk of a woman dying from pregnancy and related complications is almost 40 times greater than that of her counterparts in developed countries (Benson & Yinger, 2002). Maternal mortality remains a public health challenge worldwide, and the global maternal mortality ratio of 525 per 100,000 live births annually is still unacceptably high (Hogan, 2010). A disproportionately high burden of these maternal deaths is borne by developing countries including Nigeria, with a maternal mortality ratio of 500– 1,000 per 100,000 live births (World Bank, 2013). These deaths arise from pregnancy, childbirth or postpartum complications. According to WHO (2009), maternal deaths are thought to occur in developing countries due to delay in deciding to seek appropriate care, delay in reaching an appropriate health facility, and delay in receiving adequate emergency care once at a facility. These delays may be reduced if pregnant women and their families are prepared for birth and its complications. Birth preparedness and complication readiness strategy is therefore, very relevant in this regard.This strategy can reduce the number of women dying from complications due to such delays by making a birth plan that constitutes birth-preparedness and complication-readiness measures for pregnant women, their spouses and their families (McPherson, Khadka, Moore & Sharma, 2006). Adequate health care provision and utilisation for women during pregnancy is essential to ensure the normal, healthy evolution of the pregnancy and to prevent, detect, or predict potential complications during pregnancy and/or delivery (Berrin., Okka., Yasemin.,&Durduran, 2016). Good quality care must be provided by skilled health personnel who are well trained and equipped to detect potential complications and provide the necessary attention or referral (Karkee., Lee., & Binns, 2013). When complications occur, the unprepared family wastes a great deal of time in recognizing the problem, getting organized, getting money, finding transport, and reaching the appropriate referral facility (Ekabua et al., 2011). This often results in avoidable delays in obtaining life-saving emergency services that could prevent maternal deaths. Birth preparedness is a comprehensive strategy to improve the use of skilled providers at birth and the key interventions to decrease maternal mortality(Tura, Afework, & Yalew, 2014). Birth preparedness and complication readiness (BP/CR) strategies encourage women to be informed of the danger signs of obstetric complications and emergencies, choose a preferred birth place and attendant at birth, make advance arrangement with the attendant at birth, arrange for transport to skilled care site in case of emergency, save or arrange alternative funds for costs of skilled and emergency care, find a companion to be with the woman at birth or to accompany her to emergency care, and identify blood donors in order to facilitate swift decision-making and reduce delays in reaching a care facility when a problem arises(Nawal & Goli, 2013). Responsibilities for BP/CR must be shared among all safe motherhood stakeholders, since coordinated effort is needed to reduce the delays that contribute to maternal and newborn deaths. According to Kaso and Addisse, (2014b) the major causes of maternal deaths include postpartum hemorrhaging, hypertension, anaemia, unsafe abortions, infections and obstructed labour. Although these are the easily and most identifiable causes of maternal deaths, there are several other determinants associated with maternal deaths. For example, access to health care is often-impeded by delays: delays in deciding to seek care, delays in reaching care, and delays in receiving care (Solnes et al., 2013). These delays also have many causes, including logistic and finances, unsupportive policies and gaps in services, as well as inadequate community and family awareness and knowledge about obstetric complication issues. 1.2 Statement of Problem According to World Health Organization in 2009, maternal deaths are thought to occur in developing countries due to delay in deciding to seek appropriate care, delay in reaching an appropriate health facility, and delay in receiving adequate emergency care once at a facility. The common causes of maternal deaths are haemorrhage, postpartum infection, hypertensive disorders, obstructed labour and abortion complications. Since awareness of obstetric danger signs and adequate preparation for the birth of a baby would promote timely intervention and reduce delay in obtaining care in case of an emergency or complication, this study therefore assessed the awareness of obstetric danger signs and practice of birth preparedness among pregnant women attending antenatal clinics in Oji River, Enugu state. Despite the fact that BP/CR is essential for further improvement of maternal and child health little is known about the current magnitude of BP/CR strategies and associated factors in Nigeria especially in Oji River, Enugu state. This study, therefore, aimed at filling this gap by assessing the current status and factors associated with birth preparedness and complication readiness among couples. 1.3 Research Questions 1. What is the knowledge of couples about birth preparedness and complication readiness? 2. What factors influence access to early antenatal care? 3. What obstetric beliefs exist among expectant couples? 4. What support systems are in place in the community for pregnant women in case of emergency childbirth? 1.4 Objectives of the study 1. To assess the knowledge of couples about birth preparedness and complication readiness. 2. To enumerate the factors influence access to early antenatal care. 3. To examine if obstetric beliefs exist among expectant couples. 4. To investigate if support systems are in place in the community for pregnant women in case of emergency childbirth. 1.5 Significance of the Study This study hopes to produce a document that will be used to educate expectant couples on birth preparedness and complication readiness. The study seeks to promote skilled care for all births and encourage decision making before the onset of labour and thereby reduce delay in deciding to seek care. This study provides information that can be used to encourage households and communities to put in place emergency response systems regarding childbirth to avoid delays in seeking timely obstetric care. The findings of this study may be useful to Nigeria Health Service and other stakeholders in the healthcare system for proactive policy making. The results also avail information and data for advocacy to promote facility based childbirth in rural communities in and outside Nigeria and therefore serves as reference document for further research. 1.6 Scope of the study This study was carried out on assessing knowledge, practice and factors influencing birth preparedness and complication readiness among couples. The study was limited to clinics in Oji Rivier L.G.A, Enugu state. 1.7 Limitations The limitations of this study were: information on birth preparedness (BP) was based on self-reports from study respondents; recall bias is thus likely to be introduced as women did not have written documents on BP and were likely to have forgotten older events related to BP practices. To minimize this, women who had infants more than 6 months of age at the time of survey were excluded. Secondly, the study was facility based and might thus not indicate the true rate of BP practice in the community. It was also difficult to establish a temporal relationship as the study design was cross-sectional. Despite these limitations, the trained health personnel used in data collection as research assistants made it less difficult explaining the concepts to participants and findings from this study are most likely to be valid, reliable and contribute to the understanding of the factors associated with BP practice in the study area. 1.8 Organization of the Study This study is composed of five chapters. Chapter one (1) introduces the topic and provides the background to the study. It covers the statement of the problem, the study’s objectives and research questions which guided the study. It ends with purpose, significance, delimitation, limitation, operational definition of terms, abbreviations and organization of the research study. Chapter two (2) reviews the literature on concept of birth preparedness and maternal health from the global to local context, maternal health services availability and accessibility, obstetric beliefs in pregnancy and childbirth, family support for pregnant women, community support system during emergency delivery, and the theoretical framework underpinning the study.
Keywords: ASSESSING KNOWLEDGE, PRACTICE AND FACTORS INFLUENCING BIRTH PREPAREDNESS AND COMPLICATION READINESS AMONG COUPLES
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