ABSTRACT
Background: According to UNICEF, globally 800 million women die due to preventable causes related to pregnancy and childbirth; 20% of which occur in India. It is therefore imperative to understand the level of knowledge about danger signs among pregnant women to augment timely redressal of preventive obstetric causes of mortality.Methods: A hospital based, cross sectional study was conducted at the ANC Clinic in Safdarjung Hospital, New Delhi from 2nd July to 27th July 2018. Convenient sampling was used to identify and interview 354 pregnant women, using a semi structured questionnaire. Data was entered and analysed with SPSSv21. Results were presented as frequencies and proportions. Chi square was used to test for association between qualitative variables, and p-value less than 0.05 was considered significant.Results: 48.3%, 35.6%, and 40.1% of pregnant women had knowledge about danger signs during pregnancy, labour and postpartum respectively. Majority of the women had knowledge about abdominal pain (58.4%) and severe fatigue (80.7%) as danger signs of pregnancy, while bleeding (82.5%) was the most common response as danger sign of labour. More than half had knowledge about heavy bleeding (59.9%) as danger sign of postpartum. The women lacked awareness about Convulsions (92.9%) as danger signs of pregnancy and labour, as well as smelly vaginal discharge (79.6%) in postpartum.Conclusions: Knowledge of obstetric danger signs among pregnant women is still lower. It needs further awareness as it can help in early diagnosis and referral of patients thus reducing maternal mortality and morbidity.
ABSTRACT
Aims: Behavior change communication (BCC) has been recommended in maternal health however, little is known about its effectiveness in improving knowledge and utilization of services. This paper presents findings from Matlab, a rural area of Bangladesh to inform policy about the effect of focused BCC on maternal knowledge and institutional delivery rates. Study Design: Cohort Study. Place and Duration of Study: The study took place in Matlab, Bangladesh from the period 2003 to 2006. Method: The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) introduced pictorial cards in 1996 to monitor all pregnant women in Matlab service area and to provide BCC during routine antenatal visits on pregnancy danger signs, birth planning and maternal nutrition. Maternal knowledge was measured by asking about complications shown on the pictorial cards during 1st and 2nd (or successive) antenatal visits. The pictorial card data were linked with the birth file data and the socioeconomic survey data of the year 2005 of Matlab Health and Demographic Surveillance Systems (HDSS) for analysis. Results: HDSS recorded 11,150 births during the study period but pictorial cards covered 10,657 women, and maternal knowledge data was available from 6,624 of these. Knowledge about all 5 danger signs increased from 8.9% to 34.2% between 1st and 2nd (or successive) antenatal visits (P <.001). Women with complete knowledge of all five pregnancy danger signs were 1.13 (Adjusted Odds: 1.13, 95% CI, 1.01-1.27) times more likely to have institutional deliveries than those without knowledge when the effect of socio-demographic co-variates were held constant. Conclusion: Focused BCC using pictorial cards during antenatal visits improves knowledge regarding 5 pregnancy danger signs which has clear implications for improving institutional delivery rates. We recommend implementation research to demonstrate the effect of focused BCC in improving knowledge and practice to address high maternal mortality in resource-poor settings.