INTRODUCTION: Lack of information on the warning signs of complications during pregnancy, parturition and postpartum hampers women's ability to partake fully in safe motherhood initiatives. We assessed the extent to which women in 19 countries of sub-Saharan Africa recall receiving information about pregnancy complications during antenatal care for the most recent pregnancy, and examined the impact of advice receipt on the likelihood of institutional delivery. METHODS: A cross-sectional, cross-country analysis was performed on data from the most recent Demographic and Health Surveys (DHS) of 19 countries of sub-Saharan Africa. Multilevel logistic regressions were used to predict the probability of receiving information and delivering in a health centre, by clinical risk factors (age, parity, previous pregnancy termination), social factors (area of residence, education), and the frequency of service utilization (number of visits). RESULTS: The percentage of women recalling information about potential complications of pregnancy during antenatal care varied widely, ranging from 6% in Rwanda to 72% in Malawi, and in 15 of the 19 countries, less than 50% of women reported receiving information. Institutional delivery ranged from 29% (Ethiopia) to 92% (Congo Brazzaville). Teenagers (OR = 0.84), uneducated (OR = 0.65) and rural women (OR = 0.70) were less likely to have been advised, compared with women aged 20-34 years, women with secondary education and urban women, respectively. Likelihood of recalling information increased with the number of antenatal visits. Advice reception interacts with the number of antenatal visits to increase the likelihood of institutional delivery. CONCLUSION: There is a high level of unmet need for information on pregnancy complications in sub-Saharan Africa, particularly among those who face significant barriers to accessing care if complications occur. Educational interventions are critical to safe motherhood initiatives; health providers must fully use the educational opportunity in antenatal care.
INTRODUCTION: Lack of information on the warning signs of complications during pregnancy, parturition and postpartum hampers women's ability to partake fully in safe motherhood initiatives. We assessed the extent to which women in 19 countries of sub-Saharan Africa recall receiving information about pregnancy complications during antenatal care for the most recent pregnancy, and examined the impact of advice receipt on the likelihood of institutional delivery. METHODS: A cross-sectional, cross-country analysis was performed on data from the most recent Demographic and Health Surveys (DHS) of 19 countries of sub-Saharan Africa. Multilevel logistic regressions were used to predict the probability of receiving information and delivering in a health centre, by clinical risk factors (age, parity, previous pregnancy termination), social factors (area of residence, education), and the frequency of service utilization (number of visits). RESULTS: The percentage of womenrecalling information about potential complications of pregnancy during antenatal care varied widely, ranging from 6% in Rwanda to 72% in Malawi, and in 15 of the 19 countries, less than 50% of women reported receiving information. Institutional delivery ranged from 29% (Ethiopia) to 92% (Congo Brazzaville). Teenagers (OR = 0.84), uneducated (OR = 0.65) and rural women (OR = 0.70) were less likely to have been advised, compared with women aged 20-34 years, women with secondary education and urban women, respectively. Likelihood of recalling information increased with the number of antenatal visits. Advice reception interacts with the number of antenatal visits to increase the likelihood of institutional delivery. CONCLUSION: There is a high level of unmet need for information on pregnancy complications in sub-Saharan Africa, particularly among those who face significant barriers to accessing care if complications occur. Educational interventions are critical to safe motherhood initiatives; health providers must fully use the educational opportunity in antenatal care.
Authors: Jillian Pintye; Alison L Drake; Emily Begnel; John Kinuthia; Felix Abuna; Harison Lagat; Julia Dettinger; Anjuli D Wagner; Harsha Thirumurthy; Kenneth Mugwanya; Jared M Baeten; Grace John-Stewart Journal: AIDS Date: 2019-07-01 Impact factor: 4.177
Authors: Crystal L Patil; Elizabeth T Abrams; Carrie Klima; Chrissie P N Kaponda; Sebalda C Leshabari; Susan C Vonderheid; Martha Kamanga; Kathleen F Norr Journal: Midwifery Date: 2013-07-19 Impact factor: 2.372
Authors: Jillian Pintye; John Kinuthia; D Allen Roberts; Anjuli D Wagner; Kenneth Mugwanya; Felix Abuna; Harison Lagat; George Owiti; Carol E Levin; Ruanne V Barnabas; Jared M Baeten; Grace John-Stewart Journal: J Acquir Immune Defic Syndr Date: 2018-12-15 Impact factor: 3.731
Authors: Andrea B Pembe; Anders Carlstedt; David P Urassa; Gunilla Lindmark; Lennarth Nyström; Elisabeth Darj Journal: BMC Pregnancy Childbirth Date: 2010-07-01 Impact factor: 3.007
Authors: Christopher Pell; Arantza Meñaca; Florence Were; Nana A Afrah; Samuel Chatio; Lucinda Manda-Taylor; Mary J Hamel; Abraham Hodgson; Harry Tagbor; Linda Kalilani; Peter Ouma; Robert Pool Journal: PLoS One Date: 2013-01-15 Impact factor: 3.240
Authors: Yalem Tsegay; Tesfay Gebrehiwot; Isabel Goicolea; Kerstin Edin; Hailemariam Lemma; Miguel San Sebastian Journal: Int J Equity Health Date: 2013-05-14