Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh

Abstract

BackgroundBirth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh.ObjectivesTo describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices.MethodsA cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis.ResultsLess than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband’s education (OR = 1.3; CI: 1.1–1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2–3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2–1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0–1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9–3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9–3.1), practice clean cord care (OR = 1.3, CI: 1.0–1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0–3.2) or their newborn (OR = 2.6, CI: 2.1–3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3–2.6).ConclusionGreater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low performing districts in Bangladesh.

Birth preparedness and complication readiness among women and couples and its association with skilled birth attendance in rural Bangladesh

“…When taking these variations into account, birth planning in Netrokona seems to be generally lower than in many of the other contexts reported on. However, the level of planning seems to be consistent with other hard to reach areas of Bangladesh [ 5 ].…”

“…Most countries, including Bangladesh, have declared their commitment to achieve these targets, which will require countries to maximize their efforts to ensure access to and utilization of MNH care [ 4 ]. In addition to continued investment in increasing availability, readiness and quality of MNH services, birth preparedness and complication readiness (BPCR) can play a significant role in overcoming the barriers related to access to and utilization of skilled MNH care [ 5 – 11 ].…”

“…To date, some evidence exists regarding the status of BPCR practice in Bangladesh [ 5 ], however there is no evidence correlating how these practices contribute to the use of skilled MNH care or the value of male involvement in BPCR in this context. Our study aims to explore the status of BPCR in a hard-to-reach area of rural Bangladesh and to demonstrate how practices related to BPCR among women and among couples contribute to ensuring birth in the presence of a skilled birth attendant.…”

Care-seeking practices for sick neonates: Findings from cross-sectional survey in 14 rural sub-districts of Bangladesh

“…Around 25% of areas in Bangladesh are considered to be hard-to-reach. Details of the interventions, their evaluation designs, and the study settings are available elsewhere [ 19 ]. In summary, the objective of the cRCT was to evaluate an integrated package of Maternal, Neonatal and Child Survival (MNCS) interventions that was implemented by the Ministry of Health and Family Welfare, Government of Bangladesh and UNICEF in partnership with other NGOs.…”

The Effectiveness of Community-Based Continuous Training on Promoting Positive Behaviors towards Birth Preparedness, Male Involvement, and Maternal Services Utilization among Expecting Couples in Rukwa, Tanzania: A Theory of Planned Behavior Quasi-Experimental Study

“…Questionnaires on knowledge about birth preparedness and complication readiness were adopted and modified from monitoring BPCR tools for maternal and newborn health [ 25 ]. Several studies have adopted this tool [ 26 , 27 ]. After modification, it contained five sections, namely, sociodemographic information, obstetric history, danger signs (during pregnancy, labor and childbirth, 42 days after delivery, and neonatal danger signs), antenatal care, and preparations for childbirth.…”