Assessing knowledge, practice and factors influencing birth preparedness and complication readiness among couples in rural communities in Enugu state Nigeria

Background: Maternal mortality is a global health problem with a ratio of 525/100,000 live births annually, which is still unacceptably high. A disproportionately high burden of these maternal deaths is borne in developing countries including Nigeria. Among the many strategies initiated for the reduction of maternal mortality such as making pregnancy safer and lifesaving skills; this study focuses on birth preparedness and complication readiness. Birth preparedness and complication readiness involves planning with key stakeholders, the health care providers, pregnant women, relations and the community for positive pregnancy outcome. It helps women to reach skilled birth attendants when labour begins thereby reducing delays that occur when mothers in labourexperience obstetric complications. This strategy contributes to the reduction of maternal and newborn mortality through making appropriate birth plan. Objectives: The aims of the study were to determine knowledge of birth preparedness and complication readiness in the study population, determine the couple’s practice, identify factors that hinder couples practice and establish relationship between couple’s socio-economic status and their practice of birth preparedness and complication readiness. Methods and Materials: A cross-sectional descriptive survey design was used for the study. Snowball non- probability sampling technique was used to select subjects for the study. Descriptive and inferential statistics were used to analyse data at 0.05 level of significance. Results: Major findings of the study revealed that 307(78.7%) couples had good knowledge while 25(6.4%) showed poor knowledge. The danger signs during pregnancy were well understood by more than 60% of the study population which includes prolonged labour (63%) and heavy vaginal bleeding (70.3%). Only 76 respondents (19.4%) of the study population engaged in good birth preparedness and complication readiness practices. Antenatal care attendance was poor with only 104 (26.7%) attending. Twenty three percent (88) of the couples made plans to deliver at a specific health facility while 274(70%) arranged for a birth companion. Major factors that hindered practice were financial constraint, lack of transport at night and premature delivery. Conclusion: Although most of the couples had good knowledge but this did not translate into practice. There is need to address these limiting factors, especially transportation for better pregnancy outcome in emergencies. The study recommends a slight shift of focus by government from hospital based to community based in maternal and child health projects for better rural coverage.