Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison
Introduction: Maternal mortality is a major public health problem. Birth preparedness and complication readiness (BP/CR) constitute a veritable strategy for reducing maternal mortality, yet adoption is low with wide urban–rural discrepancies. Objectives: The objectives of this study were to compare...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-04-01
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| Series: | Nigerian Postgraduate Medical Journal |
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| Online Access: | https://journals.lww.com/10.4103/npmj.npmj_275_23 |
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| author | Onyinye Ginika Mba Ibitein Ngowari Okeafor |
| author_facet | Onyinye Ginika Mba Ibitein Ngowari Okeafor |
| author_sort | Onyinye Ginika Mba |
| collection | DOAJ |
| description | Introduction:
Maternal mortality is a major public health problem. Birth preparedness and complication readiness (BP/CR) constitute a veritable strategy for reducing maternal mortality, yet adoption is low with wide urban–rural discrepancies.
Objectives:
The objectives of this study were to compare the practice of BP/CR amongst women in rural and urban areas of Rivers State, Nigeria, and determine the individual-level predictors.
Methods:
A facility-based cross-sectional comparative study using a multistage sampling method was employed in the selection of 924 (462 urban and 462 rural) women who gave birth within the last 12 months in urban and rural local government areas. Outcome measures were birth preparedness (defined as undergoing antenatal care (ANC) with a skilled birth provider, voluntary counselling and testing for HIV and saving money for childbirth at an agreed place of delivery with a skilled birth attendant) and complication readiness (defined as being knowledgeable about danger signs, identifying decision-maker, a nearest functional institution in case of emergency, emergency means of transport and funds and a suitable blood donor). Bivariate and multivariate analyses were performed at P < 0.05.
Results:
The proportion of women who were birth prepared was significantly higher amongst women in urban areas (85.9%; 95% confidence interval [CI]: 82.7%–89.1%) versus rural counterparts (56.7%; 95% CI: 52.2%–61.2%), whereas the proportion of complication readiness was significantly higher in rural (31.8%; 95% CI: 27.6%–36.1%) than urban (18.2%; 95% CI: 15.2%–47.8%) groups. Predictors were possession of secondary educational level or higher (adjusted odds ratio [AOR]: 4.9; 95% CI: 1.5–15.5), being employed (AOR: 2.7; 95% CI: 1.5–15.0) and ANC attendance (AOR: 29.2; 95% CI: 8.8–96.9) in urban, whereas amongst the rural, it was ANC attendance (AOR: 20.0; 95% CI: 9.1–43.7).
Conclusion:
In urban areas, more women were birth prepared while fewer women were complication ready compared to the women in rural areas, with predictors such as education, employment and ANC attendance in urban areas and only ANC attendance in rural areas. Measures to promote ANC uptake, maternal education and empowerment could promote BP/CR. |
| format | Article |
| id | doaj-art-f42ac103bc884a9d893f50be42983e55 |
| institution | Kabale University |
| issn | 1117-1936 2468-6875 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Nigerian Postgraduate Medical Journal |
| spelling | doaj-art-f42ac103bc884a9d893f50be42983e552025-01-25T06:14:43ZengWolters Kluwer Medknow PublicationsNigerian Postgraduate Medical Journal1117-19362468-68752024-04-0131210211010.4103/npmj.npmj_275_23Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural ComparisonOnyinye Ginika MbaIbitein Ngowari OkeaforIntroduction: Maternal mortality is a major public health problem. Birth preparedness and complication readiness (BP/CR) constitute a veritable strategy for reducing maternal mortality, yet adoption is low with wide urban–rural discrepancies. Objectives: The objectives of this study were to compare the practice of BP/CR amongst women in rural and urban areas of Rivers State, Nigeria, and determine the individual-level predictors. Methods: A facility-based cross-sectional comparative study using a multistage sampling method was employed in the selection of 924 (462 urban and 462 rural) women who gave birth within the last 12 months in urban and rural local government areas. Outcome measures were birth preparedness (defined as undergoing antenatal care (ANC) with a skilled birth provider, voluntary counselling and testing for HIV and saving money for childbirth at an agreed place of delivery with a skilled birth attendant) and complication readiness (defined as being knowledgeable about danger signs, identifying decision-maker, a nearest functional institution in case of emergency, emergency means of transport and funds and a suitable blood donor). Bivariate and multivariate analyses were performed at P < 0.05. Results: The proportion of women who were birth prepared was significantly higher amongst women in urban areas (85.9%; 95% confidence interval [CI]: 82.7%–89.1%) versus rural counterparts (56.7%; 95% CI: 52.2%–61.2%), whereas the proportion of complication readiness was significantly higher in rural (31.8%; 95% CI: 27.6%–36.1%) than urban (18.2%; 95% CI: 15.2%–47.8%) groups. Predictors were possession of secondary educational level or higher (adjusted odds ratio [AOR]: 4.9; 95% CI: 1.5–15.5), being employed (AOR: 2.7; 95% CI: 1.5–15.0) and ANC attendance (AOR: 29.2; 95% CI: 8.8–96.9) in urban, whereas amongst the rural, it was ANC attendance (AOR: 20.0; 95% CI: 9.1–43.7). Conclusion: In urban areas, more women were birth prepared while fewer women were complication ready compared to the women in rural areas, with predictors such as education, employment and ANC attendance in urban areas and only ANC attendance in rural areas. Measures to promote ANC uptake, maternal education and empowerment could promote BP/CR.https://journals.lww.com/10.4103/npmj.npmj_275_23antenatal carebirth preparednesscomplication readinessmaternal healthurban–rural |
| spellingShingle | Onyinye Ginika Mba Ibitein Ngowari Okeafor Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison Nigerian Postgraduate Medical Journal antenatal care birth preparedness complication readiness maternal health urban–rural |
| title | Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison |
| title_full | Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison |
| title_fullStr | Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison |
| title_full_unstemmed | Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison |
| title_short | Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban–Rural Comparison |
| title_sort | individual level predictors of birth preparedness and complication readiness urban rural comparison |
| topic | antenatal care birth preparedness complication readiness maternal health urban–rural |
| url | https://journals.lww.com/10.4103/npmj.npmj_275_23 |
| work_keys_str_mv | AT onyinyeginikamba individuallevelpredictorsofbirthpreparednessandcomplicationreadinessurbanruralcomparison AT ibiteinngowariokeafor individuallevelpredictorsofbirthpreparednessandcomplicationreadinessurbanruralcomparison |