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Background: Neonatal and maternal mortality are the major concerns in the country mainly due to the “three delays” in seeking, reaching, and obtaining appropriate care. Birth preparedness and complication readiness (BPACR) is one of the most important tools to assess these delays. BPACR is the process of planning for normal birth and anticipating the actions needed in case of an emergency. The current study was undertaken to assess the status of BPACR among pregnant women in rural area of Kharsiya block in Raigarh district.Methods: A community-based, cross-sectional study was conducted among 110 pregnant women in rural area of Kharsiya during January-June 2017. All the pregnant females were interviewed using a pretested and structured questionnaire. Knowledge about danger signs, planning for transport, place and delivery by skilled birth attendant, financial management were assessed. BPACR index was also calculated.Results: The BPACR index was found to be very low (27.79%). About 73.65% women identified a skilled birth attendant for delivery but, only 10% women saved money and only 2.7% women had identified a blood donor for emergency. Nearly 74.54% women had no knowledge about danger or warning signs during pregnancy while 89.09% were unaware of complications during labour and 97.27% women did not know about puerperal complications.Conclusions: BPACR index in this rural area was very low. Vast majority of women were not knowledgeable about birth preparedness and complication readiness.
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Background: The World Health Organization recommends that women be attended by skilled birth attendants (SBAs) during delivery to improve maternal and newborn health and to achieve the maternal mortality target of the sustainable development goals (SDGs). Objectives: The objectives of the study were to assess the knowledge, attitude, and utilization of SBAs among women of reproductive age in a rural community in Edo State, Nigeria. Materials and Methods: A descriptive cross-sectional study design among a total population of women of reproductive age was carried out. Data collection was by mixed methods using a pre-tested, interviewer-administered questionnaire, and focus group discussion (FGD) Guide. Ethical clearance to conduct this study was sought and obtained from the Ethical Committee, University of Benin Teaching Hospital. Quantitative data collected were analyzed using international business machines Statistical Package for the Social Sciences version 21.0 while qualitative data were analyzed thematically using ATLAS.ti software. Logistic regression was applied to calculate crude odds ratios, adjusted odds ratios (AORs), 95% confidence intervals (CIs), and p-values of the quantitative data. The level of significance was set at P < 0.05. Results: A total number of 484 persons (comprising 465 respondents and 19 FGD participants) were surveyed. The study showed good knowledge 421 (92.1%), positive attitude 405 (88.6%), and good utilization 410 (88.2%) of SBAs. The determinants of utilization of SBAs were age (AOR: 1.086 95% CI: 1.020–1.155), knowledge of respondents (AOR: 0.034 95% CI: 0.012–0.098), and cost of services (AOR: 0.348 95% CI: 0.157–0.772). Conclusion: Knowledge, attitude, and utilization of SBAs were found to be good among the studied population. The determinants of utilization should be used as major points for international electrotechnical commission in key intervention programs.
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<b>Objective</b><BR> In West African countries where the maternal mortality rate is high compared to the rest of the world, international assistance is conducted actively to improve the birth rate with the presence of Skilled Birth Attendant (SBA). However, few documents describe which workforces are considered as SBA and which work in delivery care actually on site. This paper summarizes the workforce engaged in delivery care and clarifies which are the occupations considered as SBA in West African French-speaking countries. <BR><b>Method</b><BR> Literature review was conducted based on information from official documents related to health workforce in 7 West African French-speaking countries: Benin, Burkina Faso, Ivory Coast, Mali, Niger, Senegal and Togo, and the respective governmental websites. To determine the professional categories as SBA in each country, Demographic and Health Survey (DHS) was referred.<BR><b>Result</b><BR> This research reveals that the workforces which engage in delivery care in the target countries are nurse, midwife, auxiliary nurse, auxiliary midwife, paramedical personnel, obstetric nurse, primary medical staff, matron, community health worker and traditional birth attendants. Titles and definitions of health workforce however vary in official documents issued by the government even of one country. In DHS Report, nurse and midwife are considered as SBA in all countries, but other professional categories vary in each country. In many countries, professional nurse and midwife categorized by WHO are included in SBA, while community health worker is not. Matron, which is a kind of community health worker, is considered as SBA exceptionally in Burkina Faso and Mali.<BR><b>Conclusion</b><BR> None of the countries clearly define which professional categories are considered as SBA in official documents. Urgent definition of SBA is required and simultaneously the management system of health workforce and its uniformity for description in documents are needed. It is also suggested that various SBA-related policy assistance for the reduction of the maternal mortality are conducted without clear definition of SBA in each country. Thus it is reaffirmed that the policy assistance must be planned with adequate understanding in health workforce, based on appropriate selections of workers and well considered methods of intervention in the concerned field.
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Aims: The study was conducted to obtain information about place and mode of child delivery and compare unsafe deliveries between tribal and non-tribal areas. Study Design: This was a retrospective study with the follow up of registered pregnant women in the Primary Health Centers (PHC). Place and Duration of Study: The study was conducted in the PHCs of the State of Maharashtra, India. They were divided into two groups, tribal and non-tribal. The study was carried out in 2009-10. Method: A format was prepared to obtain details of delivery of children by women. The Auxiliary Nurse Midwives filled the format for all the pregnant women registered during calendar year 2008, through house to house visits in their respective areas. Results: More than one million pregnancies were registered. There were 21.88% home deliveries, of which 6.96% were not attended by a skilled birth attendant. About 5% of the babies were delivered through Cesarean section. The proportion of home deliveries (46.79%) and the absence of a skilled birth health professional (16.19%) were significantly higher in tribal areas. Even in institutional deliveries, interventional assistance was offered to lesser extent in these areas. The relative risk of undergoing unsafe delivery was 3.25 (95%, C.I. 3.20-3.29) in tribal PHCs. The district wise analysis Original Research Article British Journal of Medicine & Medical Research, 4(27): 4570-4581, 2014 4571 also supported the findings that home deliveries and overall unsafe deliveries were more in tribal districts. Conclusion: The study concludes that substantial number of women from tribal areas is exposed to unsafe deliveries.
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Background: In Myanmar a large proportion of antenatal and intrapartum care in rural areas is provided by skilled birth attendants (SBAs), this study assessed the coverage by these health workers of all births, their adherence to service guidelines, and community opinion on the antenatal and delivery care they give in two rural health centres in Pathein Township, Ayeyarwaddy Region to identify the challenges and improve antenatal and intrapartum service delivery provided by the SBAs. Method: A structured questionnaire was used to interview 304 women who had infants under one year of age, and in-depth interviews were held with 12 SBAs and 10 community members. Results: Of the 304 pregnancies, 93% had received antenatal care (ANC); 97% of these were covered by SBAs at an average 15 weeks’ gestation. The average frequency of ANC visits was 9. Rates of home and hospital deliveries were 84.5% and 13.8% respectively. Among home deliveries, use rate of SBA was 51.4%, while for postnatal care, 31.3% was given by unskilled providers (traditional birth attendants (TBAs) 17.5%, auxiliary midwives (AMWs),13.8%). Multivariate analysis showed that interviewees aged 30 years and below (OR=0.468, P=0.046), with an education at primary level and below that of husband (OR=0.391, P=0.007) or not residing in the village of the rural/station health centre (OR=0.457, P=0.011) were significantly less likely to use SBAs. The categories of supervision, referral, and health education activities of SBAs were not in line with service guidelines. The main reasons were lack of access and community acceptance of TBAs. Conclusion: Heavy workload, geographical location, transportation and financial concerns were major challenges for SBAs, along with community compliance and mutual coordination. Good communication and service management skills were important to overcome these challenges.