Knowledge Management Division, National Health Systems Resource Centre, New Delhi, India.
Department of Health Management Research, International Institute of Health Management Research, New Delhi, India.
BMC Womens Health. 2024 Feb 14;24(1):119. doi: 10.1186/s12905-024-02932-4.
Birth preparedness and complication readiness (BPCR) is an essential component of safe motherhood programs. This study aims to systematically identify and synthesize available evidence on birth preparedness and complication readiness among pregnant and recently delivered women in India.
The study followed PRISMA guidelines and used databases such as PubMed, Cochrane Library, and ProQuest. Joanna Briggs Institute [JBI] Tool was used for critical appraisal of studies. The meta-analysis was conducted using Comprehensive Meta-Analysis [CMA] tool and R studio software. Statistical heterogeneity was evaluated using visual inspection of the forest plot, Cochran's Q test, and the I statistic results. Funnel plot and Egger's tests were applied to explore the possibility of the publication bias in the studies [PROSPERO: CRD42023396109].
Thirty-five cross-sectional studies reported knowledge on one or more components of birth preparedness [BP], whilst knowledge on complication readiness [CR] or danger signs was reported in 34 included studies. Utilizing the random effect model, the pooled result showed that only about half of the women [49%; 95% CI: 44%, 53%] were aware on BPCR components. This result ranged between 15% [95% CI: 12%, 19%] to 79% [95% CI: 72%, 84%] in Maharashtra and Karnataka respectively [I = 94%, p = < 0.01]. High heterogeneity [> 90%] is observed across all components [p < 0.01]. The result of subgroup analysis indicated no significant difference in the proportion on BPCR among pregnant women [50%; 95% CI: 45%, 55%] and recently delivered women [54%; 95% CI: 46%, 62%]. However, the southern region of India indicates relatively better [56%; 95% CI: 45%, 67%] prevalence.
Our study highlights the low prevalence of BPCR in India and the factors associated with it. Scaling up cost-effective interventions like BPCR that have a positive overall effect is necessary. Authors strongly suggests that birth preparedness and complication readiness should be given utmost importance to reduce maternal morbidity and mortality to achieve the Sustainable Development Goals. Consideration should be given to fortifying existing resources, such as frontline workers and primary healthcare, as a strategic approach to augmenting the effectiveness of awareness initiatives.
生育准备和并发症准备（BPCR）是安全孕产方案的重要组成部分。本研究旨在系统地识别和综合印度孕妇和近期分娩妇女在生育准备和并发症准备方面的现有证据。
本研究遵循 PRISMA 指南，并使用了 PubMed、Cochrane 图书馆和 ProQuest 等数据库。采用 Joanna Briggs 研究所（JBI）工具对研究进行批判性评估。使用 Comprehensive Meta-Analysis（CMA）工具和 R 工作室软件进行荟萃分析。使用森林图的直观检查、Cochran's Q 检验和 I 统计结果评估统计异质性。使用漏斗图和 Egger 检验探讨研究中的发表偏倚可能性[PROSPERO：CRD42023396109]。
35 项横断面研究报告了对生育准备[BP]的一个或多个组成部分的知识，而 34 项纳入研究报告了对并发症准备[CR]或危险信号的知识。采用随机效应模型，汇总结果显示，只有大约一半的妇女[49%；95%CI：44%，53%]知晓生育准备组成部分。这一结果在马哈拉施特拉邦和卡纳塔克邦之间存在差异，分别为 15%[95%CI：12%，19%]至 79%[95%CI：72%，84%][I=94%，p<0.01]。所有组成部分均观察到高度异质性[>90%][p<0.01]。亚组分析结果表明，孕妇[50%；95%CI：45%，55%]和近期分娩妇女[54%；95%CI：46%，62%]之间的生育准备比例没有显著差异。然而，印度南部地区的情况相对较好[56%；95%CI：45%，67%]。
本研究强调了印度生育准备的低流行率及其相关因素。需要扩大具有积极总体效果的成本效益干预措施，如生育准备和并发症准备。作者强烈建议，应高度重视生育准备和并发症准备，以降低孕产妇发病率和死亡率，实现可持续发展目标。应考虑加强现有资源，如一线工作人员和初级卫生保健，作为增强宣传倡议效果的战略方法。
