Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India

• Published in: PloS one 2017-08, Vol.12 (8), p.e0183739-e0183739
• Main Authors: Akshaya, Kibballi Madhukeshwar, Shivalli, Siddharudha
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biology and Life Sciences; Birth; Births; Care and treatment; Childbirth & labor; Coastal zone; Complications; Control; Costs; Cross-Sectional Studies; Delivery (Childbirth); Delivery scheduling; Delivery, Obstetric; Demographic variables; Demographics; Evidence-based medicine; Female; Gestation; Hazards; Health; Health care; Health facilities; Humans; India; Laws, regulations and rules; Maternal & child health; Maternal mortality; Medical personnel; Medicine and Health Sciences; Neonates; Obstetric Labor Complications; People and Places; Population studies; Postpartum; Poverty; Pregnancy; Pregnancy complications; Rural health services; Rural Health Services - organization & administration; Social Sciences; Womens health; Workers; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0183739

Birth preparedness and complication readiness (BPCR) is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25%) under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%), childbirth (45.7%), and postnatal (17.4%) period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions. To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs) of Dakshina Kannada district, Karnataka, India. A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation) and recently delivered (in the last 6 months) women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six) was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR. Proportion, Odds ratio, and adjusted Odds ratio (adj OR) for optimal BPCR practice. A total of 184 women completed the exit interview (mean age: 26.9±3.9 years). Optimal BPCR practice was observed in 79.3% (95% CI: 73.5-85.2%) of the women. Multivariate logistic regression revealed that age >26 years (adj OR = 2.97; 95%CI: 1.15-7.7), economic status of above poverty line (adj OR = 4.3; 95%CI: 1.12-16.5), awareness of minimum two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (adj OR = 3.98; 95%CI: 1.4-11.1), preference to private health