Document Type : Original Article
Authors
- . Mukesh Shukla
- . Nahid Zia Khan
- . Anjana Agarwal
- . Akhilesh Dutta Dwivedi
- . Jai Vir Singh
- . Shahnoor Alam
Departments of Community Medicine and Obstetrics and Gynaecology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
Abstract
CONTEXT: Measures related to birth preparedness and complication readiness (BPCR) during
pregnancy play an important role in producing better pregnancy outcome. If the pregnant females are
properly counseled during antenatal visits, it could help in bringing out desirable behavior changes.
AIMS: This study aims to study BPCR‑related awareness and practices among the pregnant females
and the effect of focused and structured birth preparedness counseling on complication readiness
among pregnant females.
SUBJECT AND METHODS: A facility‑based follow‑up study was conducted from July to December
2016, and a total of 130 pregnant females were enrolled. All study participants were initially assessed
for various domains of BPCR index consisting of seven key indicators. The index reassessment
was done again, after 1 month, during follow‑up visit. Information regarding any pregnancy‑related
complication in due course and behavior was also recorded during successive follow‑up.
STATISTICAL ANALYSIS USED: The difference in pre‑ and postcounseling mean BPCR index was
assessed using paired t‑test, and McNemar’s test was used for paired categorical data analysis.
P < 0.05 was considered to be statistically significant.
RESULTS: The postcounseling BPCR index (70.65 ± 19.18) was found to be significantly much
higher as compared to pre‑counseling baseline BPCR index (41.12 ± 11.34). Knowledge about
danger signs of pregnancy, transportation services provided by government, financial assistance
provided in Government schemes, identification of skilled birth attendant, mode of transportation,
and arrangement of emergency blood donor was found to increase significantly after counseling.
Abortion was found to occur significantly higher (about thrice) among those who had postcounseling
BPCR index below average, i.e., <50% (P < 0.05).
CONCLUSIONS: The results of the present study revealed that focused birth preparedness
counseling on complication readiness could play an important role in increasing the baseline
knowledge of pregnant females regarding pregnancy‑related complications and bring out desirable
ideal health‑seeking behavior changes during pregnancy.
Keywords
2011‑2013. Available from: http://www.censusindia.gov.in/
vital_statistics/mmr_bulletin_2011‑13.pdf. [Last accessed on
2016 Jun 12].
2. International Institute of Population Sciences and ORC Macro.
National Family Health Survey‑4: State Fact Sheet. Available from:
http://www.rchiips.org/nfhs/factsheet_NFHS‑4.shtml. [Last
accessed on 2018 Jun 12].
3. Park K. Park’s Textbook of Preventive and Social Medicine.
Preventive Medicine in Obstetrics, Paediatrics and Geriatrics.
23rd ed., Ch. 9. Jabalpur, India: Bhanot Publishers; 2015. p. 521.
4. 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;28:383‑91.
5. Maternal and Neonatal Health. Monitoring Birth Preparedness
and Complication Readiness, Tools and Indicators for Maternal
and Newborn Health. Johns Hopkins, Bloomberg School of
Public Health, Center for Communication Programs, Family Care
International; 2004. Available from: http://www.jhpiego.org/
files/BPCRtoolkit.pdf. [Last accessed on 2016 Jun 12].
6. National Institution for Transforming India, Government of
India. State Statistics. Available from: https://www.niti.gov.in/
content/maternal‑mortality‑ratio‑mmr‑100000‑live‑births. [Last
accessed on 2018 Dec 12].
7. International Institute of Population Sciences and ORC Macro.
National Family Health Survey‑4: Uttar Pradesh State Fact Sheet.
Available from: http://www.rchiips.org/nfhs/pdf/NFHS4/
UP_FactSheet.pdf. [Last accessed on 2018 Jan 20].
8. Nandan D, Kushwah SS, Dubey DK, Singh G, Shivdasani JP,
AdishV. Study for Assessing Birth Preparedness and Complication
Readiness Intervention in Rewa District of Madhya Pradesh.
New Delhi: National Institute of Health and Family Welfare;
2009. Available From: http://www.nihfw.org/pdf/RAHI‑II%20
Reports/REWA.pdf. [Last accessed on 2016 May 12].
9. Lwanga SK. Sample Size Determination in Health Studies’ a
Practical Manual. Geneva: World Health Organization; 1991.
p. 25‑6.
10. Khairnar MR, Wadgave U, Shimpi PV. Updated BG Prasad
socioeconomic classification for 2016. JIndian Assoc Public Health
Dent 2016;14:469‑70.
11. Akshaya KM, Shivalli S. Birth preparedness and complication
readiness among the women beneficiaries of selected rural
primary health centers of Dakshina Kannada district, Karnataka,
India. PLoS One 2017;12:e0183739.
12. Waghmare R, Wavare RR, Chiwhane A. Determinants of birth
preparedness and complication readiness among adoloscent
pregnant women in field practice area of rural health and training
centre, Manglia, Indore. Paripex Indian J Res 2018;7:59‑61.
13. Acharya AS, Kaur R, Prasuna JG, 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;40:127‑34.
14. Mazumdar R, Mukhopadhyay D, Kole S, Mallik D, Sinhababu A.
Status of birth preparedness and complication readiness in a rural
community: A study from West Bengal, India. Al Ameen J Med
Sci 2017;7:52‑7.
15. Mukhopadhyay DK, Mukhopadhyay S, Bhattacharjee S, Nayak S,
Biswas AK, Biswas AB, et al. Status of birth preparedness and
complication readiness in Uttar Dinajpur district, West Bengal.
Indian J Public Health 2013;57:147‑54.
16. 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.
17. Hailu M, Gebremariam A, Alemseged F, Deribe K. Birth
preparedness and complication readiness among pregnant
women in Southern Ethiopia. PloS One 2011;6:e21432.
18. 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;14:282.
19. Kabakyenga JK, Östergren PO, 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:e35747.
20. Bintabara D, Mohamed MA, Mghamba J, Wasswa P,
Mpembeni RN. Birth preparedness and complication readiness
among recently delivered women in Chamwino district, central
Tanzania: A cross sectional study. Reprod Health 2015;12:44.
21. Timša L, Marrone G, Ekirapa E, Waiswa P. Strategies for helping
families prepare for birth: Experiences from eastern central
Uganda. Glob Health Action 2015;8:23969.
22. Nithya R, Dorairajan G, Chinnakali P. Do pregnant women know
about danger signs of pregnancy and childbirth? A study of the
level of knowledge and its associated factors from a tertiary care
hospital in Southern India. Int J Adv Med Health Res 2017;4:11‑17.
23. Ekabua JE, Ekabua KJ, Odusolu P, Agan TU, Iklaki CU,
Etokidem AJ, et al. Awareness of birth preparedness and
complication readiness in Southeastern Nigeria. ISRN Obstet
Gynecol 2011;2011:560641.
24. Kabakyenga JK, Östergren PO, Turyakira E, Pettersson KO.
Knowledge of obstetric danger signs and birth preparedness
practices among women in rural Uganda. Reprod Health
2011;8:33.
25. Kaso M, Addisse M. Birth preparedness and complication
readiness in robe Woreda, Arsi Zone, Oromia region, central
Ethiopia: A cross‑sectional study. Reprod Health 2014;11:55.
26. Ishola G, Fayehun F, Isiugo‑Abanihe U, Segun T, Yusuf S, Orji B,
et al. Effect of volunteer household counseling in improving
knowledge of birth preparedness and complication readiness
of pregnant women in Northwest Nigeria. Afr J Reprod Health
2017;21:39‑48.
27. Devkota R, Khan GM, Alam K, Sapkota B, Devkota D. Impacts
of counseling on knowledge, attitude and practice of medication
use during pregnancy. BMC Pregnancy Childbirth 2017;17:131.
28. Hudson I, Gatongi PM, Nyongesa P, Makwali J, Mudany M. The
impact of birth preparedness on pregnancy outcome: findings
from Lurambi Sub county, Kakamega county, Kenya. J Pregnancy
Child Health 2016;3:269.
29. Patel NA, Mehta JP, Unadkat SV, Yadav SB. Birth preparedness:
studying its effectiveness in improving maternal health in urban
slums of Jamnagar, Gujarat. Int J Community Med Public Health
2017;4:4569‑76.