TY - JOUR
T1 - Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania
T2 - a community-based cross-sectional survey
AU - Orwa, James
AU - Gatimu, Samwel Maina
AU - Mantel, Michaela
AU - Luchters, Stanley
AU - Mugerwa, Michael A.
AU - Brownie, Sharon
AU - Subi, Leonard
AU - Mrema, Secilia
AU - Nyaga, Lucy
AU - Edwards, Grace
AU - Mwasha, Loveluck
AU - Isangula, Kahabi
AU - Selestine, Edna
AU - Jadavji, Sofia
AU - Pell, Rachel
AU - Mbekenga, Columba
AU - Temmerman, Marleen
N1 - Funding Information:
The study used quantitative baseline data from the AQCESS (Access to Quality Care through Extending and Strengthening Health Systems) and IMPACT (Improving Access to Reproductive, Maternal and Newborn Health in Mwanza) projects, both executed by the Aga Khan Foundation Canada with funding from the Government of Canada, being implemented in Kenya and Tanzania, respectively. The projects aim to contribute to the reduction of maternal and neonatal mortality in Kisii (Bomachoge Borabu sub-county) and Kilifi (Kaloleni/Rabai sub-counties) counties in Kenya and Mwanza region (Illemela, Nyamagana, Buchosa, Sengerema, Ukerewe, Misungwi, Kwimba and Magu districts) in Tanzania. Bomachoge Borabu sub-county is one of the nine sub-counties in Kisii County with a population of 129,617 people. In 2015, the county had 53.3% of health facilities deliveries and 76.6% deliveries assisted by skilled providers []. Kaloleni and Rabai are coastal sub-counties in Kilifi County with a population of 304,778; 52.6% health facility deliveries and 52.3% skilled birth attendance []. Mwanza region lies in the northern part of Tanzania and has a population of 2,772,509 people; 57.2% of the women attending at least four ANC visits and 75.3% hospital delivery []. The two countries and the regions within the countries were chosen due to their high maternal mortality [, ].
Funding Information:
We are grateful to the Government of Canada, and the Aga Khan Foundation Canada for funding the baseline survey from which data were extracted for this study. We acknowledge the Ministry of Health for the two countries, the village elders, and village executive officers for support in conducting this study. We are grateful to participants who consented for the interviews and the AQCESS and IMPACT teams in Kenya and Tanzania (Kennedy Mulama, Eunice Siaty Pallangyo, Tumbwene E Mwansisya, David Siso, Rachel Odhiambo, Erica Stillo and Ibrah Sendagire).
Funding Information:
We are grateful to the Government of Canada, and the Aga Khan Foundation Canada for funding the baseline survey from which data were extracted for this study. We acknowledge the Ministry of Health for the two countries, the village elders, and village executive officers for support in conducting this study. We are grateful to participants who consented for the interviews and the AQCESS and IMPACT teams in Kenya and Tanzania (Kennedy Mulama, Eunice Siaty Pallangyo, Tumbwene E Mwansisya, David Siso, Rachel Odhiambo, Erica Stillo and Ibrah Sendagire).
Funding Information:
The baseline surveys that collected data used for this study were funded by the Government of Canada and the Aga Khan Foundation Canada (AKFC) as part of AQCESS and IMPACT projects which were implemented by the Aga Khan Development Network in partnership with the Government of Kenya and Tanzania and local communities. AKFC contributed to the design and data collection of the baseline survey and in writing of the manuscript. The funders had no role in the analysis and interpretation of the data presented in this manuscript. Acknowledgements
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania. Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study. Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78). Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
AB - Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania. Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study. Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78). Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
KW - BPCR
KW - Birth preparedness
KW - Complications readiness
KW - Eastern Africa
KW - Kenya
KW - Maternal health
KW - Obstetric danger signs
KW - Pregnancy
KW - Safe motherhood
KW - Tanzania
UR - http://www.scopus.com/inward/record.url?scp=85092760294&partnerID=8YFLogxK
U2 - 10.1186/s12884-020-03329-5
DO - 10.1186/s12884-020-03329-5
M3 - Article
C2 - 33076869
AN - SCOPUS:85092760294
SN - 1471-2393
VL - 20
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
IS - 1
M1 - 636
ER -
