birth preparedness, complication readiness and associated factors among pregnant women in agnuak zone, gambella regional state, Ethiopia: community based comparative cross-sectional study

Abstract

Background: Birth Preparedness and Complication Readiness interventions have a significant reduction in maternal and neonatal mortality risk. However, one of the major reasons for high maternal deaths recorded in sub Saharan Africa was inadequacy or lack of birth and emergency preparedness. Objective: To assess birth preparedness, complication readiness and associated factors among women in Agnuak zone, Gambella regional state, March, 2017. Methods: Community based Comparative cross-sectional study design supplemented by qualitative data collection method was conducted from March 10 to April 10, 2017. Multi-stage stratified random sampling technique was used to identify 411 women in urban and 209 in rural setting. Interviewer administered data collection method was used for quantitative method. Data were entered into EpiData and analyzed using SPSS version 21. Birth preparedness was measured using five items then women who score at least three were considered as well prepared. Bivariate logistic regression was performed to identify candidate variables and multivariable logistic regression to control confounders. The results were presented as frequency table and Odds Ratio with 95% CI. Qualitative data were collected from purposely selected 54 members of the community by using open ended/guiding questionnaire and analyzed in line of study objective manually. Result: A total of 403 urban and 200 rural women were included in the study with response rate of 97.3%. The prevalence of birth preparedness and complication readiness was found to be 23.4% and significantly higher in urban respondents (25.8% urban and 18.5% rural, p<0.05). Being in urban residence, having occupation of government employee or merchant, higher wealth quintile, were among socio-economic and demographic factors found to increase the likelihood of preparation for birth and its complications. Mothers with history of obstetric complication, who knew at least three key danger signs, having favourable attitude, who started antenatal care visit during first trimester, had at least four antenatal care visits were among the factors found to increase the likelihood of preparation for birth and its complications. Conclusion and Recommendation: Prevalence of birth preparedness and complication readiness was very low in urban and rural area, though significantly higher in urban area. Knowledge of a key danger signs, attitude of women, antenatal care visit use, occupational status were identified as significant predictors of birth preparedness and complication rediness. There should be health information and education to all pregnant women to improve birth and emergency preparedness at individual and community level.