Centre of Excellence Women and Child Health/MERL, Aga Khan University, P. O. Box 30270-00010, Nairobi, Kenya.
Department of Population Health, Aga Khan University, Nairobi, Kenya.
BMC Pregnancy Childbirth. 2020 Oct 19;20(1):636. doi: 10.1186/s12884-020-03329-5.
Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.
We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016-2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.
Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14-2.20, secondary: aOR: 2.24, 95% CI: 1.39-3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15-2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80-2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93-2.67), postpartum (aOR: 2.69, 95% CI: 1.24-5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13-1.78).
Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
在资源匮乏的国家，延迟寻求医疗服务仍是导致孕产妇和新生儿死亡的可预防因素之一。避免这种延迟的一些策略包括为分娩做好早期准备和发现危险信号。本研究旨在评估肯尼亚和坦桑尼亚的分娩和并发症准备情况（BPCR）的实践水平和相关因素。
我们在肯尼亚的基利菲和基西县以及坦桑尼亚的姆万扎地区开展了基于社区的多阶段横断面调查，纳入了在调查前两年分娩的妇女（2016-2017 年）。至少提到五个 BPCR 组成部分中的三个的妇女被认为是有充分准备的。使用二变量和多变量比例优势比模型来确定与 BPCR 相关的因素。本研究的设计和报告遵循 STROBE 横断面研究指南。
肯尼亚和坦桑尼亚分别只有 11.4%（59/519）和 7.6%（31/409）的妇女对分娩及其并发症有充分准备，而分别有 39.7%和 30.6%的妇女没有准备。教育程度（小学：调整后的优势比（aOR）：1.59，95%可信区间（CI）：1.14-2.20；中学：aOR：2.24，95% CI：1.39-3.59）、在医疗机构分娩（aOR：1.63，95% CI：1.15-2.29）、怀孕期间对危险信号有较好的认识（aOR：1.28，95% CI：0.80-2.04）、分娩和产后（aOR：1.57，95% CI：0.93-2.67）和产前护理（aOR：1.42，95% CI：1.13-1.78）与 BPCR 相关。
总的来说，基利菲、基西和姆万扎地区的大多数孕妇对分娩及其并发症没有做好准备。提高教育水平、提高备孕期、孕期、分娩期和产后期对危险信号的认识，并鼓励妇女及其男性伴侣/家属进行产前护理和熟练的分娩护理，这些都是促进 BPCR 实践和改善母婴妊娠结局的推荐策略。
