Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Factors influencing implementation of interventions to promote birth preparedness and complication readiness

Authors: Andrea Solnes Miltenburg, Yadira Roggeveen, Jos van Roosmalen, Helen Smith

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

Login to get access

Abstract

Background

The recent WHO report on health promotion interventions for maternal and newborn health recommends birth preparedness and complications readiness interventions to increase the use of skilled care at birth and to increase timely use of facility care for obstetric and newborn complications. However, these interventions are complex and relate strongly to the context in which they are implemented. In this article we explore factors to consider when implementing these interventions.

Methods

This paper reports a secondary analysis of 64 studies on birth preparedness and complication readiness interventions identified through a systematic review and updated searches. Analysis was performed using the Supporting the Use of Research Evidence (SURE) framework to guide thematic analysis of barriers and facilitators for implementation.

Results

Differences in definitions, indicators and evaluation strategies of birth preparedness and complication readiness interventions complicate the analysis. Although most studies focus on women as the main target group, multi-stakeholder participation with interventions occurring simultaneously at both community and facility level facilitated the impact on seeking skilled care at birth. Increase in formal education for women most likely contributed positively to results. Women and their families adhering to traditional beliefs, (human) resource scarcities, financial constraints of women and families and mismatches between offered and desired maternity care services were identified as key barriers for implementation.

Conclusions

Implementation of birth preparedness and complication readiness to improve the use of skilled care at birth can be facilitated by contextualizing interventions through multi-stakeholder involvement, targeting interventions at multiple levels of the health system and ensuring interventions and program messages are consistent with local knowledge and practices and the capabilities of the health system.
Appendix
Available only for authorised users
Literature
1.
Solnes Miltenburg A, Roggeveen Y, Shields L, van Elteren M, van Roosmalen J, Stekelenburg J, Portela A. Impact of birth preparedness and complication readiness interventions on birth with a skilled attendant: a systematic review. PlosOne. 2015;10(11):e0143382.CrossRef
2.
JHPIEGO/Maternal and Neonatal Health (MNH) Program. Birth Preparedness and Complication Readiness: A Matrix of Shared Responsibility. Baltimore, MD; 2001.
3.
Carroli G, Villar J, Piaggio G, Khan-Neelofur D, Gülmezoglu M, Mugford M, et al. WHO systematic review of randomised controlled trials of routine antenatal care. Lancet. 2001;357:1565–70.CrossRefPubMed
4.
Di Mario S, Basevi V, Gori G, Spettoli D. What is the effectiveness of antenatal care? (supplement). WHO Regional Office for Europe Health Evidence Network: Copenhagen; 2005.
5.
World Health Organization. WHO recommendations on health promotion interventions for maternal and newborn health 2015. 2015.
6.
Solnes Miltenburg A, Roggeveen Y, van Elteren M, Shields L, Bunders J, van Roosmalen J, et al. A protocol for a systematic review of birth preparedness and complication readiness programs. Syst Rev. 2013;2(1):11.CrossRefPubMedPubMedCentral
7.
The mapping “Health system and community-based interventions for improving maternal health and for reducing maternal health inequalities in low- and middle-income countries: a two-stage mixed-methods research synthesis” was conducted under the European Union “Multilateral Association for Studying Health inequalities and enhancing north-south and south-south Cooperation” (MASCOT) project and the MH-SAR project (Maternal Health South Africa-Rwanda funded by the Netherlands Organization for Scientific Research. The WHO provided technical and financial support during the mapping for reviewers to identify articles addressing health promotion interventions for maternal health, including birth preparedness and complications readiness.
8.
Kabakyenga JK, Ostergren P-O, Turyakira E, Pettersson KO. Influence of birth preparedness, decision-making on location of birth and assistance by skilled birth attendants among women in south-western Uganda. PLoS One. 2012;7(4):e35747.CrossRefPubMedPubMedCentral
9.
Urassa DP, Pembe AB, Mganga F. Birth preparedness and complication readiness among women in Mpwapwa district, Tanzania. Tanzan J Health Res. 2012;14:1–7.
10.
Agarwal S, Sethi V, Srivastava K, Jha PK, Baqui AH. Birth preparedness and complication readiness among slum women in Indore city, India. J Health Popul Nutr. 2010;28(4):383–91.CrossRefPubMedPubMedCentral
11.
Hiluf M, Fantahun M. Birth preparedness and complication readiness among women in Adigrat town, north Ethiopia. Ethiop J Heal Dev. 2007;22(1):14–20.
12.
Dickerson T, Simonsen S, Samen A. Pregnancy and village outreach Tibet a descriptive report of a community- and home-based maternal-newborn outreach program in rural Tibet. J Perinat Neonat Nurs. 2010;24(2):113–25.CrossRef
13.
Mukhopadhyay DK, Mukhopadhyay S, Bhattacharjee S, Nayak S, Biswas AK, Biswas AB. Status of birth preparedness and complication readiness in Uttar Dinajpur District, West Bengal. Indian J Public Health. 2013;57:147–54.CrossRefPubMed
14.
Magoma M, Requejo J, Campbell OMR, Cousens S, Filippi V. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention. BMC Pregnancy & Childbirth. 2010;10:13.CrossRef
15.
Kuteyi EAA, Kuku JO, Lateef IC, Ogundipe JA, Mogbeyteren T, Banjo MA. Birth preparedness and complication readiness of pregnant women attending the three levels of health facilities in Ife central local government, Nigeria. Journal of Community Medicine & Primary Health. 2011;23:1–2.
16.
Kakaire O, Kaye DK, Osinde MO. Male involvement in birth preparedness and complication readiness for emergency obstetric referrals in rural Uganda. Reprod Health. 2011;8:12.CrossRefPubMedPubMedCentral
17.
Kabakyenga JK, Östergren P-O, Turyakira E, Pettersson KO. Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda. Reprod Health. 2011;8:33.CrossRefPubMedPubMedCentral
18.
Iliyasu Z, Abubakar IS, Galadanci HS, Aliyu MH. Birth preparedness, complication readiness and fathers’ participation in maternity care in a northern Nigerian community. Afr J Reprod Health. 2010;14(1):21–32.PubMed
19.
Ekabua JE, Ekabua KJ, Odusolu P, Agan TU, Iklaki CU, Etokidem AJ. Awareness of birth preparedness and complication readiness in southeastern Nigeria. ISRN Obstet Gynecol. 2011;2011:560641.PubMedPubMedCentral
20.
Choudhury N, Ahmed SM. Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study. BMC Pregnancy Childbirth. 2011;11:15.CrossRefPubMedPubMedCentral
21.
Hailu M, Gebremariam A, Alemseged F, Deribe K. Birth preparedness and complication readiness among pregnant women in southern Ethiopia. PLoS One. 2011;6:e21432.CrossRefPubMedPubMedCentral
22.
Jennings L, Yebadokpo AS, Affo J, Agbogbe M. Antenatal counseling in maternal and newborn care: use of job aids to improve health worker performance and maternal understanding in Benin. BMC Pregnancy Childbirth. 2010;10(1):75.CrossRefPubMedPubMedCentral
23.
McPherson R, Tamang J, Hodgins S, Pathak LR, Silwal RC, Baqui AH, et al. Process evaluation of a community-based intervention promoting multiple maternal and neonatal care practices in rural Nepal. BMC Pregnancy Childbirth. 2010;10:31.CrossRefPubMedPubMedCentral
24.
Stanton CK. Methodological issues in the measurement of birth preparedness in support of safe motherhood. Eval Rev. 2004;28(3):179–200.CrossRefPubMed
25.
Magoma M, Requejo J, Campbell O, Cousens S, Merialdi M, Filippi V. The effectiveness of birth plans in increasing use of skilled care at delivery and postnatal care in rural Tanzania : a cluster randomised trial. Tropical Med Int Health. 2013;18(4):435–43.CrossRef
26.
August F, Pembe AB, Mpembeni R, Axemo P, Darj E. Men’s knowledge of obstetric danger signs. Birth Preparedness and Complication Readiness in Rural Tanzania. 2015:1–12.
27.
Kaso M, Addisse M. Birth preparedness and complication readiness in robe Woreda, Arsi Zone, Oromia Region, Central Ethiopia: a cross-sectional study 2014;11[1]:1–12.
28.
Karkee R, Lee AH, Binns CW. Birth preparedness and skilled attendance at birth in Nepal : implications for achieving millennium development goal 5. Midwifery. 2013;29(10):1206–10.CrossRefPubMed
29.
Markos D, Bogale D. Birth preparedness and complication readiness among women of child bearing age group in Goba woreda, Oromia region, Ethiopia. BMC Pregnancy Childbirth. 2014;14(1):1–9.CrossRef
30.
31.
Pasha O, McClure EM, Wright LL, Saleem S, Goudar SS, Chomba E, et al. A combined community- and facility-based approach to improve pregnancy outcomes in low-resource settings: a global network cluster randomized trial. BMC Med. 2013;11(1):215.CrossRefPubMedPubMedCentral
32.
Taleb F, Perkins J, Ali NA, Capello C, Ali M, Santarelli C. Transforming maternal and newborn health social norms and practices to increase utilization of health services in rural Bangladesh: a qualitative review. BMC Pregnancy Childbirth. 2015;15:75.CrossRefPubMedPubMedCentral
33.
Tura G, Afework MF, Yalew AW. The effect of birth preparedness and complication readiness on skilled care use : a prospective follow-up study in Southwest Ethiopia. Reprod Health 2014;11[1]:1–10.
34.
Mbalinda SN, Nakimuli A, Kakaire O, Osinde MO, Kakande N, Kaye DK. Does knowledge of danger signs of pregnancy predict birth preparedness ? A critique of the evidence from women admitted with pregnancy complications. Health Res Policy Syst. 2014;12(1):1–7.CrossRef
35.
Debelew G, Afework M, Yalew AW. Factors affecting birth preparedness and complication readiness in Jimma zone. Southwest Ethiopia: a multilevel analysis. 2014;8688:1–14.
36.
Acharya A, Kaur R, Prasuna J, Rasheed N. Making pregnancy safer—birth preparedness and complication readiness study among antenatal women attendees of a primary health center, Delhi. Indian J Community Med. 2015;40(2):127–34.CrossRefPubMedPubMedCentral
37.
Soubeiga D, Gauvin L, Hatem M. A, Johri M. Birth preparedness and complication readiness [BPCR] interventions to reduce maternal and neonatal mortality in developing countries: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2014;14:129.CrossRefPubMedPubMedCentral
38.
Soubeiga D, Sia D, Gauvin L. Increasing institutional deliveries among antenatal clients: effect of birth preparedness counselling. Health Policy Plan. 013:1–10.
39.
40.
41.
Smith HJ, Colvin CJ, Richards E, Roberson J, Sharma G, Thapa K, Gülmezoglu AM. Programmes for advance distribution of misoprostol to prevent post-partum haemorrhage: a rapid literature review of factors affecting implementation. Health Policy Plan. 2015;
42.
Skinner J, Rathavy T. Design and evaluation of a community participatory, birth preparedness project in Cambodia. Midwifery. 2009;25(6):738–43.CrossRefPubMed
43.
Hossain J, Ross SR. The effect of addressing demand for as well as supply of emergency obstetric care in Dinajpur, Bangladesh. IJOG. 2006;92(3):320–8.
44.
Turan J, Tesfagiorghis M, Polan M. Evaluation of a community intervention for promotion of safe motherhood in eritrea. J Midwifery Womens Health. 2011;56(1):8–17.CrossRefPubMedPubMedCentral
45.
Mushi D, Mpembeni R, Jahn A. Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care, The case of Mtwara Rural District in Tanzania. BMC Pregnancy and Childbirth. 2010;10:14.CrossRefPubMedPubMedCentral
46.
Midhet F, Becker S. Impact of community-based interventions on maternal and neonatal health indicators: results from a community randomized trial in rural Balochistan, Pakistan. Reprod Health. 2010;7(1):30.CrossRefPubMedPubMedCentral
47.
Ahluwalia IB, Schmid T, Kouletio M, Kanenda O. An evaluation of a community-based approach to safe motherhood in northwestern Tanzania. IJOG. 2003;82:231–40.
48.
Karkee R, Lee AH, Binns CW. Birth preparedness and skilled attendance at birth in Nepal: implications for achieving millennium development goal 5. Midwifery. 2013;29:1206–10.CrossRefPubMed
49.
Sood S, Urvashi C, Palmer A, Molyneux I. Measuring the effects of the SIAGA behavior change campaign in Indonesia with population-based survey results. JHPIEGO: Baltimore; 2004.
50.
Sood S, Urvashi C, Mishra P, Neupane S. Measuring the effects of behavioral change intervention in Nepal with population based survey results. Baltimore: JHPIEGO; 2004.
51.
Fonseca-Becker F, Schenck-Yglesias C. Measuring the effects of behavioral change and service delivery interventions in Guatemala with population based survey results. Baltimore: JHPIEGO; 2004.
52.
Moran AC, Sangli G, Dineen R, Rawlins B, Yaméogo M, Baya B. Birth-preparedness for maternal Health : findings from Koupéla District. Burkina Faso. 2006;24(4):489–97.
53.
Family Care international. Testing Approaches for Increasing Skilled Care During Childbirth : Key Findings from Homabay and Migori Districts, Kenya. New York: Family Care International. 2007.
54.
Moore M, Copeland R, Chege I, Pido D, Griffiths M. A behavior Change Approach to investigating Factors Influencing Women’s Use of Skilled Care in Homa Bay District, Kenya. 2002. Washington, D.C.
55.
McPherson R A, Khadka N, Moore JM, Sharma M. Are birth-preparedness programmes effective? Results from a field trial in Siraha district, Nepal. J Health Popul Nutr 2006;24[4]:479–488.
56.
Family Care international. Testing Approaches for Increasing Skilled Care During Childbirth : Key Findings from Igunga District, Tanzania. New York: Family Care International. 2007.
57.
Barbey A, Faisel AJ, Myeya J, ADD M, Stavrou V, Psych MC, et al. Dinajpur SafeMother initiative final evaluation report. CARE. 2001;
58.
Kaharuza F, Mimba T, Pesa W. Birth preparedness in rural Tanzania. CARE. 2001;
59.
Kumar V, Kumar A, Das V, Srivastava NM, Baqui AH, Santosham M, et al. Community-driven impact of a newborn-focused behavioral intervention on maternal health in Shivgarh, India. Int J Gynaecol Obstet. 2012;117(1):48–55.CrossRefPubMed
60.
Roggeveen Y, Birks L, van Kats J, Manyama M, Hatfield J, JFG B, et al. Low utilization of skilled birth attendants in Ngorongoro conservation area, Tanzania: a complex reality requiring action. Health. 2013;5:71–83.CrossRef
61.
Sinha D. Empowering communities to make pregnancy safer: an intervention in rural Andhra Pradesh. Health and population innovation fellowship programme working paper, no 5. New Delhi: Population Council; 2008.
62.
Family Care International. Care-Seeking During Pregnancy, Delivery, and the Postpartum Period: A Study in Homabay and Migori Districts, Kenya. New York: Family Care International. 2003.
63.
Ahluwalia IB, Robinson D, Vallely L, Gieseker KE, Kabakama A. Sustainability of community-capacity to promote safer motherhood in northwestern Tanzania: what remains? Glob Health Promot. 2010;17(1):39–49.CrossRefPubMed
64.
Brazier E, Andrzejewski C, Perkins ME, Themmen EM, Knight RJ, Bassane B. Improving poor women’s access to maternity care: findings from a primary care intervention in Burkina Faso. Soc Sci Med. 2009;69:682–90.CrossRefPubMed
65.
Baqui AH, Rosecrans AM, Williams EK, Agrawal PK, Ahmed S, Darmstadt GL, et al. NGO facilitation of a government community-based maternal and neonatal health programme in rural India: improvements in equity. Health Policy Plan. 2008;23(4):234–43.CrossRefPubMed
66.
Mullany BC, Becker S, Hindin MJ. The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial. Health Educ Res. 2007;22(2):166–76.CrossRefPubMed
67.
Darmstadt GL, Choi Y, Arifeen SE, Bari S, Rahman SM, Mannan I, et al. Evaluation of a cluster-randomized controlled trial of a package of community-based maternal and newborn interventions in Mirzapur, Bangladesh. PLoS One. 2010;5(3):e9696.CrossRefPubMedPubMedCentral
68.
Hodgins S, McPherson R, Suvedi BK, Shrestha RB, Silwal RC, Ban B, et al. Testing a scalable community-based approach to improve maternal and neonatal health in rural Nepal. J Perinatol [Internet]. 2009;30(6):388–95.CrossRef
69.
Kumar V, Mohanty S, Kumar A, Misra RP, Santosham M, Awasthi S, et al. Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trial. Lancet. 2008;372(9644):1151–62.CrossRefPubMed
70.
Baqui A. Impact of an integrated nutrition and health programme on neonatal mortality in rural northern India. Bull World Health Organ. 2008;86(10):796–804.CrossRefPubMedPubMedCentral
71.
Baya B, Sangli G, Maiga A. Measuring the effects of behavior change interventions in Burkina Faso with populatin-based survey results. Baltimore. 2004.
72.
Hounton S, Menten J, Ouédraogo M, Dubourg D, Meda N, Ronsmans C, et al. Effects of a skilled care initiative on pregnancy-related mortality in rural Burkina Faso. Tropical Med Int Health. 2008;13(Suppl 1):53–60.CrossRef
73.
Mpembeni RN, Killewo JZ, Leshabari MT, Massawe SN, Jahn A, Mushi D, et al. Use pattern of maternal health services and determinants of skilled care during delivery in southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy Childbirth. 2007;7(1):29.CrossRefPubMedPubMedCentral
74.
Gil-González D, Carrasco-Portiño M, Ruiz MT. Knowledge gaps in scientific literature on maternal mortality: a systematic review. Bull World Health Organ. 2006;84:903–9.PubMedPubMedCentral
75.
Birks L, Powell C, Thomas A, Medard E, Roggeveen Y, Hatfield J. Promoting health, preserving culture: adapting RARE in the Maasai context of northern Tanzania. AIDS Care. 2011;23:585–92.CrossRefPubMed
Metadata
Title
Factors influencing implementation of interventions to promote birth preparedness and complication readiness
Authors
Andrea Solnes Miltenburg
Yadira Roggeveen
Jos van Roosmalen
Helen Smith
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1448-8

Other articles of this Issue 1/2017

BMC Pregnancy and Childbirth 1/2017 Go to the issue

Research article

Prescription drug use during pregnancy in Southern Tigray region, North Ethiopia

Research article

How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy?

Research article

Patterns of gestational diabetes diagnosis inside and outside of clinical guidelines

Research article

Decreased neonatal pain response after vaginal-operative delivery with Kiwi OmniCup versus metal ventouse

Research article

Approaches to health-care provider education and professional development in perinatal depression: a systematic review

Research article

The effect of induction method in twin pregnancies: a secondary analysis for the twin birth study