Awareness of Obstetric Danger Signs and Associated Factors Among Pregnant Women Who Attend Antenatal Care in Public Health Institutions of Adama City, Oromia, Ethiopia

Abstract

Improving awareness of women about obstetric danger signs of pregnancy, labor, and postpartum period is the crucial first step in accepting appropriate and timely health care service. In Ethiopia, where pregnancy related complications and maternal death is high, little is known about level of awareness of obstetric danger signs. The aim of this study was to assess Awareness of Obstetric Danger Signs and Associated Factors among Pregnant Women who attend Ante-natal care in Public Health Institutions of Adama City, Oromia, Ethiopia, 2018.Institutional based cross-sectional study was conducted from October 2017 to April 2018 and a total of 381 pregnant women were selected using Systematic random sampling technique. Interviewer administered structured Questionnaire was used to collect data. Data were cleaned and analyzed using EPI-INFO version 7 and SPSS window version 20. Bivariate and multi variable Logistic regression was used to assess association between awareness of obstetric danger signs and various independent variables.A total of 381 pregnant women were participated with 100% response rate. Of all participants about 44.4% knew seven and above obstetric danger signs of pregnancy, labor, and postpartum period. Out of the 381 participants 261 (68.5%), 240 (63%) and 164 (43%) knew at least two danger signs during pregnancy, childbirth and postpartum period, respectively. Vaginal bleeding was the most commonly mentioned danger signs of pregnancy (59.8%), labor (66.1%) and postpartum (60.4%). In multivariate logistic regression analysis, maternal and husband educational status, residence, and sources of obstetric danger signs related information were significantly associated with awareness of obstetric danger signs. Awareness of women about obstetric danger signs of pregnancy, labor, and postpartum period was low and affected by Partner & maternal educational status, sources of obstetric danger signs related information, and residence. Therefore, it needs to raise women’s awareness of danger signs and associated factors through maternal and child health service by designing appropriate strategies including provision of targeted information, education, and communication.

Knowledge regarding obstetric danger signs among pregnant women

“…Many other study findings showed a higher proportion of respondents who could mention severe vaginal bleeding as the danger sign in the intra-natal period. 16,32,34,36 However, a study conducted in Saudi Arabia, 25 Tanzania 27 and Uganda 37 showed the respondent's knowledge to be lesser than our study findings. The reason could be the perception of women that some amount of bleeding is normal during delivery.…”

“…33,29 Our study finding is lesser than the study findings of Saudi Arabia 25 and India 15 but higher than the study findings of Uganda 37 and different regions of Ethiopia. 16,23,26,32 In the present study, almost one fourth (24.2%) of the respondents mentioned severe headache as a danger signs during pregnancy which is similar to the study findings of Ethiopia 34 and India. 15 Contrast findings were found in many other studies conducted worldwide.…”

“…14 Contrast findings were observed in Karnataka, India; Adama city, Ethiopia and Angolela Tera district, Northern Ethiopia where 54.70%, 44.4% and 37.5% of the respondents respectively had adequate knowledge about obstetric danger signs. [15][16][17] The differences in the knowledge level could be due to the differences in the study setting, methodology, health service coverage and education level of respondents.…”

“…In this study, severe abdominal pain was mentioned as a dangerous sign during the antenatal period by almost two-thirds (64.9%) of the respondents which are similar to the study finding of Jewaro et al, 29 and Zaki et al 30 However, study conducted in Ethiopia shows that 32.3% of the respondents knew severe abdominal pain as the danger sign. 16 Another study conducted in Ethiopia showed that 21% of the respondents mentioned severe abdominal pain as a danger signs during pregnancy. 19 Both of these studies findings were lower than our study's finding.…”

“…15 Contrast findings were found in many other studies conducted worldwide. 16,22,23,26,30,32 These variations might be linked to differences in the perception of women regarding headache during pregnancy, exposure to media, health delivery system of different health care facilities.…”