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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Birth preparedness and complication readiness among pregnant women admitted in a rural hospital in Rwanda

Authors: Patrick Smeele, Richard Kalisa, Marianne van Elteren, Jos van Roosmalen, Thomas van den Akker

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

With an aim to prevent adverse pregnancy outcomes, ‘birth preparedness and complication readiness’ (BP/CR) promotes timely access to skilled maternal and neonatal services. Objective of this study was to assess implementation of BP/CR among pregnant women admitted with obstetric emergencies in rural Rwanda.

Methods

A cross-sectional study among pregnant women who were referred to Ruhengeri hospital between July and November 2015. The ‘Safe Motherhood questionnaire’ as developed by Jhpiego’s Maternal and Neonatal Health Program was used to collect data. Women were asked to mention key danger signs and respond as to whether they had identified: (A) skilled birth attendant, (B) location to give birth, (C) mode of transport, (D) money to cover health care expenditure. Women who answered ‘yes’ to three or four items were labeled ‘well prepared’. Multivariate logistic regression analysis was conducted to compare the ‘well prepared’ and ‘less prepared’.

Results

With regard to complication readiness, out of 350 women, 296 (84.6%), 271 (77.4%) and 288 (82.3%) could mention at least one key danger sign during pregnancy, labor and postpartum respectively, but only 23 (6.6%) could mention three or more key danger signs during all three periods. With regard to birth preparedness, 46 (13.1%) women had identified a skilled birth attendant, 68 (19.4%) birth location, 76 (21.7%) mode of transport, and 306 (87.4%) had saved money for health care costs. Seventy-eight women (22.3%) were ‘well prepared’, associated factors being first time pregnancy (adjusted Odds Ratio (aOR) = 3.2; 95% CI; 1.2–5.8), knowledge of at least two danger signs (aOR = 2.8; 95% CI; 1.7–3.9) and having been assisted by a community health worker at the antenatal clinic (aOR = 2.2, 95% CI; 1.3–3.7).

Conclusion

Knowledge of obstetric danger signs was suboptimal and birth preparedness low. We recommend review of practices regarding health promotion in antenatal care, taking care not to exclude multiparous women from messages related to birth preparedness, and do promote use of community health workers to enhance effectiveness of BP/CR.
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Metadata
Title
Birth preparedness and complication readiness among pregnant women admitted in a rural hospital in Rwanda
Authors
Patrick Smeele
Richard Kalisa
Marianne van Elteren
Jos van Roosmalen
Thomas van den Akker
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1818-x

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