1.1 Introduction
Birth preparedness and complication readiness (BPCR) is defined as a strategy that promotes timely access to skilled maternal and neonatal care, aiming to reduce delays in seeking care during pregnancy, childbirth, and the postpartum period (JHPIEGO, 2004). It involves a series of proactive measures taken by pregnant women, their partners, and families, including identifying a skilled birth attendant, selecting a healthcare facility for delivery, arranging transportation, saving money for emergencies, and recognizing danger signs in pregnancy (World Health Organization [WHO], 2015).
Knowledge and practice of BPCR among couples are crucial because partners often play a significant role in decision-making regarding maternal healthcare utilization. Studies indicate that when both partners are informed and actively involved in birth preparedness, there is a higher likelihood of timely healthcare access, adherence to antenatal care schedules, and appropriate responses to obstetric emergencies (Ekabua et al., 2018; Adewuyi et al., 2019).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Historically, maternal health initiatives in Nigeria and other sub-Saharan African countries focused largely on improving antenatal care coverage and increasing access to healthcare facilities. However, studies reported that mere access to facilities did not automatically translate into better outcomes, as delays in recognizing danger signs, arranging transport, and mobilizing resources often resulted in preventable complications (Oladapo et al., 2017). In response, BPCR programs were introduced to emphasize proactive planning by pregnant women and their partners, encouraging practices such as identifying skilled birth attendants, saving money for emergencies, and knowing the nearest healthcare facilities (Ekabua et al., 2018).
Over time, research affirmed that the involvement of both partners in BPCR was crucial, as male partners frequently influence household decision-making regarding maternal healthcare utilization. Adewuyi et al. (2019) contended that couples' joint participation in birth planning improves the likelihood of timely care-seeking during obstetric emergencies. Similarly, Nisar and White (2019) stated that despite knowledge dissemination through antenatal programs and community health interventions, socio-cultural barriers, low literacy, and financial constraints continued to impede effective birth preparedness and complication readiness among couples.
Birth preparedness and complication readiness (BPCR) is a proactive approach that ensures pregnant women, their partners, and families are adequately prepared for safe delivery and potential obstetric emergencies. According to JHPIEGO (2004), BPCR is a strategy aimed at promoting timely access to skilled maternal and neonatal care by planning for normal birth and anticipating potential complications. It involves practical steps such as identifying a skilled birth attendant, arranging transportation to a healthcare facility, saving money for emergencies, and recognizing danger signs during pregnancy and childbirth.
Several studies have highlighted the critical role of couples in ensuring effective BPCR. Ekabua et al. (2018) reported that active involvement of male partners in birth preparedness significantly improves maternal health outcomes, as decision-making in many households is often joint or male-dominated. Similarly, Adewuyi et al. (2019) asserted that when both partners possess adequate knowledge of BPCR, delays in seeking obstetric care are reduced, ultimately lowering maternal and neonatal mortality rates. Nisar and White (2019) stated that despite awareness campaigns, gaps persist in translating knowledge into practice due to socio-economic, cultural, and educational barriers. On the other hand, Oladapo et al. (2017) affirmed that limited knowledge and inadequate practice of BPCR among couples contribute to preventable maternal and neonatal complications. Factors such as financial constraints, distance to healthcare facilities, traditional beliefs, and low literacy levels are reported to hinder effective implementation of BPCR measures.
Tura, Fantahun, and Worku (2014) contended that addressing these barriers requires understanding the contextual factors influencing couples' knowledge and practices, as well as designing culturally sensitive interventions that engage both partners. The importance of BPCR is further emphasized by the World Health Organization (2015), which stated that proactive birth planning and readiness for complications are central to achieving safe motherhood and reducing preventable maternal deaths. Evidence suggests that targeted interventions that enhance awareness, promote positive health-seeking behaviors, and improve access to maternal health services are essential for improving outcomes. This study is set against the backdrop of these observations and reports, recognizing the need to assess the knowledge, practice, and factors influencing birth preparedness and complication readiness among couples.
1.3 Statement of Problems
Investigation revealed that many couples in Nigeria lack adequate knowledge and practical readiness to handle obstetric emergencies, leading to preventable maternal and neonatal morbidity and mortality (Oladapo et al., 2017; Ekabua et al., 2018). It is observed that while some couples demonstrate awareness of birth preparedness measures such as arranging for skilled birth attendants, saving money for emergencies, and identifying transportation to healthcare facilities, a significant proportion still do not fully implement these practices (Nisar & White, 2019).
Furthermore, some couples actively engage in birth planning but encounter systemic barriers such as poor quality of healthcare services, limited availability of essential obstetric care, and financial constraints that hinder effective implementation (Adewuyi et al., 2019). It is against this backdrop that this study seeks to assess the knowledge, practice, and factors influencing birth preparedness and complication readiness among couples in the study area.
1.4 Aim and Objectives of Study
The aim of this study is to assess the knowledge, practice, and factors influencing birth preparedness and complication readiness among couples in Lagos State, Nigeria. In achieving this aim, the following objectives were laid out as follows:
- To evaluate the level of knowledge of birth preparedness and complication readiness among couples.
- To examine the practice of birth preparedness measures among couples.
- To identify socio-cultural, economic, and educational factors influencing birth preparedness and complication readiness.
- To determine the barriers that hinder effective implementation of birth preparedness measures.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of knowledge of birth preparedness and complication readiness among couples?
- To what extent do couples practice birth preparedness measures?
- What socio-cultural, economic, and educational factors influence birth preparedness and complication readiness among couples?
- What barriers hinder the effective implementation of birth preparedness measures by couples?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between couples' knowledge of birth preparedness and their practice of complication readiness
- H1: There is a significant relationship between couples' knowledge of birth preparedness and their practice of complication readiness
Hypothesis Two
- H0: Barriers such as financial constraints, low literacy, and limited access to healthcare does not significantly hinder the implementation of birth preparedness measures
- H1: Barriers such as financial constraints, low literacy, and limited access to healthcare significantly hinder the implementation of birth preparedness measures
1.7 Significance of Study
The outcome of this research will serve as a guide for healthcare professionals, policymakers, and maternal health program implementers in designing effective interventions that target both partners, thereby improving maternal and neonatal health outcomes. This study will also contribute to raising awareness among couples about the importance of proactive planning for childbirth and potential complications.
Furthermore, the findings of this study will support strategies that promote male partner involvement in maternal healthcare, encourage timely decision-making, and enhance the practical implementation of birth preparedness measures. In addition, the study will guide community health programs in designing effective education campaigns that address socio-cultural and economic barriers to birth preparedness.
Lastly, the research will contribute to academic knowledge and serve as a reference for future studies on maternal and child health in Nigeria.
1.8 Scope of Study
The scope of this research is focused on assessing the knowledge, practice, and factors influencing birth preparedness and complication readiness among couples in Lagos State, Nigeria. The study targets couples accessing maternal health services in selected public healthcare facilities within Lagos State.
1.9 Limitations of the Study
The research study was limited by time constraints, as the research period was fixed and data collection was expected to be completed within a short timeframe. It was also limited by financial constraints, affecting the number of respondents and resources used for data collection.
1.10 Definition of Terms
Birth Preparedness:
According to JHPIEGO (2004), birth preparedness is the process of planning for normal childbirth while anticipating the actions to take in case of complications, including identifying a skilled birth attendant, arranging transport, and saving money.
Complication Readiness:
WHO (2015) defines complication readiness as proactive measures taken by pregnant women and their families to ensure timely response to obstetric emergencies, including recognizing danger signs and preparing resources for immediate care.
Knowledge:
Knowledge in this study refers to the understanding couples have regarding birth preparedness measures, danger signs in pregnancy, and emergency actions to take during childbirth (Ekabua et al., 2018).
Practice:
Practice refers to the actual implementation of birth preparedness and complication readiness measures by couples, such as attending antenatal care, saving funds, arranging transportation, and identifying skilled birth attendants (Adewuyi et al., 2019).
Couples:
For this study, couples refer to married or cohabiting partners who are expecting a child and jointly involved in maternal health decision-making.
Factors Influencing BPCR:
These include socio-cultural, economic, educational, and systemic determinants that affect couples' ability to prepare for childbirth and respond to complications (Tura et al., 2014).
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