Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant: A Systematic Review

Miltenburg, Andrea Solnes; Roggeveen, Yadira; Shields, Laura; Elteren, Marianne van; Roosmalen, Jos van; Stekelenburg, Jelle; Portela, Anayda

doi:10.1371/journal.pone.0143382

Cited by 56 publications

(59 citation statements)

References 49 publications

(63 reference statements)

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“…There is a need for continued focus on education and sensitisation campaigns to the community on the importance of early ANC attendance. Educational interventions which target both men and women have been reported to increase health seeking behaviour among pregnant women and improve birth preparedness and complication readiness [36,37]. However, despite their importance, most often, sensitisation campaigns are short-lived and thus they may not initiate enough change to enhance long-term behaviour change.…”

Section: Discussionmentioning

confidence: 99%

“…This is intended to ensure that couples are screened for HIV as part of the Prevention of Mother to Child Transmission (PMTCT) programme. The move is also meant to create an opportunity to provide education on danger signs during pregnancy, and on how to become birth-prepared and complication-ready [36]. Implementation of this policy, however, deters men from attending ANC mainly due to fear of HIV screening.…”

Section: Discussionmentioning

confidence: 99%

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Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis

Maluka

Joseph²,

Fitzgerald³

et al. 2020

BMC Pregnancy Childbirth

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Background: When started early in pregnancy and continued up till childbirth, antenatal care (ANC) can be effective in reducing adverse pregnancy outcomes. While the proportion of women who attend ANC at least once in low income countries is high, most pregnant women attend their first ANC late. In Tanzania, while over 51% of pregnant women complete ≥4 visits, only 24% start within the first trimester. This study aimed to understand the factors that lead to delay in seeking ANC services among pregnant women in Tanzania. Methods: This qualitative descriptive case study was conducted in two rural districts in Iringa Region in Tanzania. A total of 40 focus group discussions (FGDs) were conducted involving both male and female participants in 20 villages. In addition, 36 semi-structured interviews were carried out with health care workers, members of health facility committees and community health workers. Initial findings were further validated during 10 stakeholders' meetings held at ward level in which 450 people participated. Data were analysed using thematic approach. Results: Key individual and social factors for late ANC attendance included lack of knowledge of the importance of early visiting ANC, previous birth with good outcome, traditional gender roles, fear of shame and stigma, and cultural beliefs about pregnancy. Main factors which inhibit early ANC attendance in Kilolo and Mufindi districts include spouse accompany policy, rude language of health personnel and shortage of health care providers. Conclusions: Traditional gender roles and cultural beliefs about pregnancy as well as health system factors continue to influence the timing of ANC attendance. Improving early ANC attendance, therefore, requires integrated interventions that address both community and health systems barriers. Health education on the timing and importance of early antenatal care should also be strengthened in the communities. Additionally, while spouse accompany policy is important, the implementation of this policy should not infringe women's rights to access ANC services.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis

Maluka

Joseph²,

Fitzgerald³

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Assessment of anthropometry measures varied considerably, yet data on these will be important to avoid adverse pregnancy outcomes, given that maternal under nutrition and short maternal stature are important risk factors for stillbirths . Birth and emergency preparedness is part of the WHO's recommended focused ANC model and demonstrated to be effective for reducing neonatal and maternal mortality through its effect on improving skilled birth attendance and facility deliveries , yet DHS coverage of birth planning interventions was low, and components of birth planning assessed also varied. Birth planning was one of eight interventions with high‐quality evidence supporting its effectiveness in prevention of stillbirths ; therefore, ensuring is implementation as part of ANC packages will be important to monitor.…”

Section: Discussionmentioning

confidence: 99%

Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys

Christou

Dibley

Raynes‐Greenow

2017

Tropical Med Int Health

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Objective: To systematically map data availability for stillbirths from all countries with DHS surveys to outline the limitations and challenges with using the data for understanding the determinants and causes of stillbirths, and for cross-country comparisons. Methods:We assessed data sources from the DHS program website, including published DHS (84.2%) surveys used a live birth history with a reproductive calendar, while 16 (14.0%) surveys from 12 countries did a full pregnancy history. Based on assessment of questionnaires, antenatal and delivery care information for stillbirths was only available in 15 surveys (13.2%) from 12 countries (17.1%). Data on maternal conditions/complications were captured in 17 surveys (16.0%), but only in six could these be linked to stillbirths. Data on other recognized risk factors were scarce, varying considerably across surveys. Upon further examination of datasets from surveys with maternity care data on non-live births we found incomplete capture of these data; only two surveys had adequately and completely collected them for stillbirths. Conclusion:Substantial variation exists in DHS surveys in the measurement of stillbirths, with limited scope to examine risk factors or causes. Without immediate improvements our understanding of country-specific trends and determinants for stillbirths will remain hampered, limiting the development, and prioritization of programmatic interventions to prevent these deaths.

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“…Our systematic review on the impact of birth preparedness and complication readiness (BPCR) interventions on birth with a skilled attendant revealed that BPCR is a complex intervention, highly dependent on the context in which it is implemented [ 1 ]. We also found that BPCR interventions vary in terms of approaches, actors involved, in definitions applied, in outcomes measured and in the strategies used to evaluate them.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing implementation of interventions to promote birth preparedness and complication readiness

Miltenburg

Roggeveen²,

Roosmalen³

et al. 2017

BMC Pregnancy Childbirth

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BackgroundThe recent WHO report on health promotion interventions for maternal and newborn health recommends birth preparedness and complications readiness interventions to increase the use of skilled care at birth and to increase timely use of facility care for obstetric and newborn complications. However, these interventions are complex and relate strongly to the context in which they are implemented. In this article we explore factors to consider when implementing these interventions.MethodsThis paper reports a secondary analysis of 64 studies on birth preparedness and complication readiness interventions identified through a systematic review and updated searches. Analysis was performed using the Supporting the Use of Research Evidence (SURE) framework to guide thematic analysis of barriers and facilitators for implementation.ResultsDifferences in definitions, indicators and evaluation strategies of birth preparedness and complication readiness interventions complicate the analysis. Although most studies focus on women as the main target group, multi-stakeholder participation with interventions occurring simultaneously at both community and facility level facilitated the impact on seeking skilled care at birth. Increase in formal education for women most likely contributed positively to results. Women and their families adhering to traditional beliefs, (human) resource scarcities, financial constraints of women and families and mismatches between offered and desired maternity care services were identified as key barriers for implementation.ConclusionsImplementation of birth preparedness and complication readiness to improve the use of skilled care at birth can be facilitated by contextualizing interventions through multi-stakeholder involvement, targeting interventions at multiple levels of the health system and ensuring interventions and program messages are consistent with local knowledge and practices and the capabilities of the health system.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1448-8) contains supplementary material, which is available to authorized users.

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Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant: A Systematic Review

Cited by 56 publications

References 49 publications

Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis

Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis

Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys

Factors influencing implementation of interventions to promote birth preparedness and complication readiness

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