1.0 Introduction
1.1 Background of Study
Birth preparedness has been globally endorsed as an essential component of safe motherhood programs to reduce delays to care-seeking for obstetric emergencies - delay in recognition of problem, delay in seeking care, and delay in receiving care at facility. These delays represent barriers that often result in preventable maternal deaths. The presence of a skilled birth attendant (SBA) at delivery is recognized as essential to preventing maternal mortality (JHPIEGO, 2004b; McPherson et al., 2006).
The principle and practice of Birth Preparedness and Complication readiness (BP/CR) in a third world setting where there is prevailing illiteracy, inefficient infrastructure, poor transport system, and unpredictable access to skilled care provider have the potential of reducing the existing high maternal and neonatal morbidity and mortality rates. BP/CR promotes skilled care for all births and encourages decision making before the onset of labor (Ekabua et al., 2011).
Birth preparedness and complication readiness (BP/CR) is a comprehensive package aimed at promoting timely access to skilled maternal and neonatal services (Markos and Bogale, 2014; Kaso and Addisse, 2014). It includes knowledge of danger signs, planning for a birth attendant and birth location, arranging transportation, identifying a blood donor, and saving money in the case of an obstetric complication (Mbalinda et al., 2014; Urassa and Pembe, 2012).
The safe motherhood plan of the Ministry of Health and Population defines a range of complementary interventions to improve maternal and newborn health, one of which is the birth-preparedness package (BPP). The purpose of the package is to encourage pregnant women, their families, and communities to plan for normal pregnancies, deliveries, and postnatal periods and to prepare to deal effectively with emergencies if they occur. The BPP is a demand-creation intervention that promotes key messages and behaviour change via inter-personal communication through community health volunteers (McPherson et al., 2006; DOHS, 2014)
The majority of pregnant women and their families do not know how to recognize the danger signs of complications and when complications occur they will waste a great deal of time in recognizing the problem, getting organized, getting money, finding transport and reaching the appropriate referral facility (Moore et al., 2002). With the assumption that “every pregnancy faces risks”, women should be made aware of danger signs of obstetric complications during pregnancy, delivery and the postpartum, the knowledge will ultimately empower them and their families to make prompt decisions to seek care from skilled birth attendants (Kabakyenga et al., 2011).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge and Practices of Birth Preparedness and Complication Readiness Among Mothers Attending Antenatal Care Clinic.
1.2 Statement of Problems
Investigation revealed that despite the well documented record of safety, the strong aversion of women in sub-Saharan Africa tot eh procedure especially in the presence of life threatening indications is a great concern (Awoyinka BS, 2006). Hence the researcher wants to assess the Quality of Care Rendered in Primary Health Care Facilities and the perception of patients at the antenatal clinic to know if it is accepted or not and the factors that influences their attitudes towards cesarean section.
Effects on Mothers: It has been estimated that 25 percent of maternal deaths occur during pregnancy, with variability between countries depending on the prevalence of unsafe abortion, violence, and disease in the area.
Effects on Babies: In sub-Saharan Africa, an estimated 900,000 babies die as stillbirths during the last twelve weeks of pregnancy. It is estimated that babies who die before the onset of labour, or antepartum stillbirths, account for two-thirds of all stillbirths in countries where the mortality rate is greater than 22 per 1,000 births nearly all African countries. Antepartum stillbirths have a number of causes, including maternal infections notably syphilis and pregnancy complications, but systematic global estimates for causes of antepartum stillbirths are not available. Newborns are affected by problems during pregnancy including preterm birth and restricted fetal growth, as well as other factors affecting the baby’s development such as congenital infections and fetal alcohol syndrome.
1.3 Aim and Objectives of Study
This aim of the study is to assess the Knowledge and Practices of Birth Preparedness and Complication Readiness Among Mothers Attending Antenatal Care Clinic in UNTH Enugu. In achieving this aim, the following objectives were laid out as follows:
- To determine knowledge regarding birth preparedness and complication readiness of mothers in the study area;
- To evaluate the knowledge on Birth Preparedness and Complication readiness and obstetric danger signs; and
- To find out the association between knowledge regarding birth preparedness and complication readiness and place of delivery.
1.4 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:
- Are Mothers attending antenatal care clinic aware about Knowledge and Practices of Birth Preparedness and Complication readiness?
- Do mothers have knowledge about the danger signs of BP/CR during pregnancy?
- Is there any association between the knowledge regarding BP/CR and socio-demographic characteristics of Mothers Attending Antenatal Care Clinic in UNTH Enugu?
- Is there any association between knowledge and practices of birth preparedness and complication readiness regarding danger signs during pregnancy?
1.5 Research Hypothesis
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 the knowledge regarding BP/CR and socio-demographic characteristics of Mothers Attending Antenatal Care Clinic in UNTH Enugu
- H1: There is significant relationship between the knowledge regarding BP/CR and socio-demographic characteristics of Mothers Attending Antenatal Care Clinic in UNTH Enugu
Hypothesis Two
- H0: There is no significant relationship between knowledge and practices of birth preparedness and complication readiness regarding danger signs during pregnancy
- H1: There is significant relationship between knowledge and practices of birth preparedness and complication readiness regarding danger signs during pregnancy
1.6 Significance of Study
The findings of this research will provide information on appropriate sources of care making the care-seeking process more efficient. It also encourages households and communities to set aside money for transport and service fees, avoiding delays in reaching care caused by the search for funds (Ekabua et al., 2011).
This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.7 Scope of Study
The scope of this research is focused on the Assessment of Knowledge and Practices of Birth Preparedness and Complication Readiness Among Mothers Attending Antenatal Care Clinic in UNTH Enugu.
1.8 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.9 Definition of Terms
Knowledge: To have information about something because you have experience or because you have learned it or be told.
Anaesthesia: The state in which one is unable to feel anything especially pain by injecting drug into the body.
Attitude: The way one behaves towards somebody or something that shows how you think or feel.
Cesarean Section: It is an operative technique by which a fetus is delivered through an abdominal and uterine incision and the indications can either be maternal or fetal.
