Birth preparedness, utilization of skilled birth attendants and delivery outcomes among pregnant women in Ogun State, Nigeria
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Department of Nursing Science, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
Ogun State School of Nursing and Midwifery, Idi-aba, Nigeria
Adekemi E. Olowokere   

Department of Nursing Science, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Ogun State, 220005, Nigeria
Publication date: 2020-05-28
Submission date: 2019-12-30
Final revision date: 2020-03-05
Acceptance date: 2020-04-06
Eur J Midwifery 2020;4(May):22
Birth preparedness and complication readiness (BPCR) is an approach initiated to facilitate utilization of skill birth attendants (SBAs) for improved pregnancy outcomes. Despite its usefulness, many women still did not use skilled birth attendants. The purpose of this study is to assess the level of birth preparedness and complication readiness and its association with skilled birth attendants’ utilization.

A descriptive sequential mixed methods design was used. In all, 350 women in their third trimester were purposively selected from healthcare facilities. Of these, 340 completed the study yielding a 97% response rate. Structured interviewer-administered questionnaire, a checklist and an in-depth interview guide were used to collect data. Data analysis was done in Statistical Package for Social Sciences version 20 using descriptive and inferential statistics at 0.05 level of significance while qualitative data were analyzed through content analysis.

There was a significant association between level of birth preparedness and complication readiness and use of skilled birth attendants [χ2(2, 340)=19.96; p=0.0001]. Some negative delivery outcomes (complications) were significantly associated with nonutilization of skill birth attendants. Cost, family members’ preference, distance, industrial action and irritation from the vaginal examination were factors that prevented women from using a skilled birth attendant.

The study concluded that BPCR is significantly associated with the use of SBAs and better outcomes were observed in women that used SBAs in Nigeria.

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
There was no source of funding for this research.
Not commissioned; externally peer reviewed.
World Health Organization. Trends in maternal mortality: 1990 to 2015: Estimates by WHO, UNICEF, UNFPA, World Bank and the United Nations Population Division, Geneva, Switzerland. Geneva, Switzerland: World Health Organization; 2015. Accessed December 30, 2019.
Khumanthem P, Chanam M, Samjetshabam R. Maternal Mortality and Its Causes in a Tertiary Center. J Obstet Gynaecol India. 2012;62(2):168-171. doi:10.1007/s13224-012-0169-1
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(1):33. doi:10.1186/1742-4755-8-33
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(8):e0183739. doi:10.1371/journal.pone.0183739
JHPIEGO. Monitoring birth preparedness and complication readiness tools and indicators for maternal and newborn health. Baltimore, MA: Johns Hopkins University; 2004. Accessed December 30, 2019.
World Health Organization. Maternal Health in Nigeria: Generating information for action. Published 2019. Accessed December 30, 2019.
Ekabua J, Ekabua K, Odusolu P, Agan T, Iklaki C, Etokidem A. Awareness of Birth Preparedness and Complication Readiness in Southeastern Nigeria. ISRN Obstet Gynecol. 2011;2011:560641. doi:10.5402/2011/560641
Akinwaare M, Oluwatosin A. Birth Preparedness and Complication Readiness among Pregnant Women Attending Antenatal Classes at Primary Health Center in Ibadan, Nigeria. Open Journal of Obstetrics and Gynecology. 2019;9(10):1358-1364. doi:10.4236/ojog.2019.910131
Ibadin SH, Adam VY, Adeleye O, Okojie OH. Birth Preparedness and Complication Readiness among Pregnant Women in a Rural Community in Southern Nigeria. South African Journal of Obstetrics and Gynecology. 2016;22(2):42-51. doi:10.7196/sajog.2016.v22i2.1088
Sabageh A, Adeoye O, Adeomi A, Sabageh D, Adejimi A. Birth preparedness and complication readiness among pregnant women in Osogbo Metropolis, Southwest Nigeria. Pan Afr Med J. 2017;27:74. doi:10.11604/pamj.2017.27.74.7266
Ifeanyichukwu O, Obehi O, Richard K. Birth Preparedness and Complication Readiness: Attitude and Level of Preparedness among Pregnant Women in Benin City, Edo State, Nigeria. Br J Med Med Res. 2016;15(6):1-14. doi:10.9734/bjmmr/2016/25127
Ogun State Government. Antenatal Care Attendees Records. Ogun State Government Official Website. Published 2016. Accessed December 30, 2019.
Cochran WG. Sampling techniques. 3rd ed. New York, NY: John Wiley & Sons; 1954. doi:10.2307/2573260
Iliyasu Z, Abubakar IS, Galadanci HS, Aliyu MH. Birth preparedness, complication readiness and fathers' participation in maternity care in a northern Nigerian community. Afr J Reprod Health. 2010;14(1):21-32. PMID:20695136.
Bintabara D, Mohamed MA, Mghamba J, Wasswa P, Mpembeni RNM. Birth preparedness and complication readiness among recently delivered women in chamwino district, central Tanzania: a cross sectional study. Reprod Health. 2015;12(1):44. doi:10.1186/s12978-015-0041-8
Zepre K, Kaba M. Birth preparedness and complication readiness among rural women of reproductive age in Abeshige district, Guraghe zone, SNNPR, Ethiopia. Int J Womens Health. 2017;9:11-21. doi:10.2147/IJWH.S111769
Asrat T, Baraki N, Assefa N, Alemkere G. Birth Preparedness among Women Who Gave Birth in the Last Twelve Months in Jardega Jarte District, Western Ethiopia. Journal of Pregnancy. 2019;2019:1-8. doi:10.1155/2019/6473725
Ijang Y, Cumber S, Nkfusai C, Venyuy M, Bede F, Tebeu P. Awareness and practice of birth preparedness and complication readiness among pregnant women in the Bamenda Health District, Cameroon. BMC Pregnancy Childbirth. 2019;19(1). doi:10.1186/s12884-019-2511-4
Bitew Y, Awoke W, Chekol S. Birth Preparedness and Complication Readiness Practice and Associated Factors among Pregnant Women, Northwest Ethiopia. Int Sch Res Notices. 2016;2016:1-8. doi:10.1155/2016/8727365
Rajesh P, Swetha R, Rajanna MS, Iyengar K, Mahesh SH, Gowda C. A study to assess the birth preparedness and complication readiness among antenatal women attending district hospital in Tumkur, Karnataka, India. Int J Community Med Public Health. 2016;3(4):919-924. doi:10.18203/2394-6040.ijcmph20160929
Kaso M, Addisse M. Birth preparedness and complication readiness in Robe Woreda, Arsi Zone, Oromia Region, Central Ethiopia: a cross-sectional study. Reproductive Health. 2014;11(1). doi:10.1186/1742-4755-11-55
Envuladu EA, Agbo HA, Lassa S, Kigbu JH, Zoakah AI. Factors determining the choice of a place of delivery among pregnant women in Russia village of Jos North, Nigeria: achieving the MDGs 4 and 5. Int J Med Biomed Res. 2013;2(1):23-27. doi:10.14194/ijmbr.215
Egharevba J, Pharr J, van Wyk B, Ezeanolue E. Factors Influencing the Choice of Child Delivery Location among Women Attending Antenatal Care Services and Immunization Clinic in Southeastern Nigeria. Int J MCH AIDS. 2017;6(1):82-92. doi:10.21106/ijma.213
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(4):e35747. doi:10.1371/journal.pone.0035747
Solnes Miltenburg A, Roggeveen Y, Shields L, van Elteren M, van Roosmalen J, Stekelenburg J, Portela A. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant: A Systematic Review. PLoS One. 2015;10(11):e0143382. doi:10.1371/journal.pone.0143382
Liambila WN, Kuria SN. Birth attendance and magnitude of obstetric complications in Western Kenya: a retrospective case-control study. BMC Pregnancy Childbirth. 2014;14(1):311. doi:10.1186/1471-2393-14-311
Cheelo C, Nzala S, Zulu J. Banning traditional birth attendants from conducting deliveries: experiences and effects of the ban in a rural district of Kazungula in Zambia. BMC Pregnancy Childbirth. 2016;16(1):323. doi:10.1186/s12884-016-1111-9
Gabrysch S, Campbell OM. Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 2009;9(1):34. doi:10.1186/1471-2393-9-34
Esena RK, Sappor MM. Factors associated with the utilisation of skilled delivery services in the Ga East Municipality of Ghana part 2: Barriers to skilled delivery. International Journal of Scientific & Technology Research. 2013;2(8):195-207. Accessed December 30, 2019.
Adedokun ST, Uthman OA. Women who have not utilized health Service for Delivery in Nigeria: who are they and where do they live? BMC Pregnancy Childbirth. 2019;19(1):93. doi:10.1186/s12884-019-2242-6
Ettarh RR, Kimani J. Influence of Distance to Health Facilities on the Use of Skilled Attendants at Birth in Kenya. Health Care for Women International. 2014;37(2):237-249. doi:10.1080/07399332.2014.908194
Tanou M, Kamiya Y. Assessing the impact of geographical access to health facilities on maternal healthcare utilization: evidence from the Burkina Faso demographic and health survey 2010. BMC Public Health. 2019;19(1):838. doi:10.1186/s12889-019-7150-1
Olowokere A, Onyeamaobi C, Olowokere I. Use and Perception of Hospital-based Maternity Care Services among Women in Selected Communities of Ife Central LGA, Osun State, Nigeria. Afr J Midwifery Womens Health. 2017;11(1):17-25. doi:10.12968/ajmw.2017.11.1.17
Iyaniwura CA, Yussuf Q. Utilization of antenatal care and delivery services in Sagamu, south western Nigeria. Afr J Reprod Health. 2009;13(3):111-22. PMID:20690266.
Downe S, Gyte GML, Dahlen HG, Singata M. Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term. Cochrane Database Syst Rev. 2013:CD010088. doi:10.1002/14651858.cd010088.pub2