Obstetric Danger Signs: Knowledge, Attitude, Health-Seeking Action, and Associated Factors among Postnatal Mothers in Nekemte Town, Oromia Region, Western Ethiopia—A Community-Based Cross-Sectional Study

Abstract

Background. Maternal mortality remains unacceptably high due to pregnancy complications and remains the major health problems in many developing countries such as Ethiopia. Having poor knowledge of obstetric danger signs contributes to delays in seeking and receiving skilled care which in turn increases maternal mortality. However, in Ethiopia, studies are lacking regarding the knowledge level of mothers about obstetric danger signs during pregnancy, child birth, and postnatal periods. In Ethiopia, the proportion of those who have full knowledge of these obstetric danger signs during pregnancy, child birth, and postnatal period is not known. Despite few studies are conducted at health facility level focusing on danger signs during pregnancy, the issue of health-seeking action after identifying danger signs and attitude of mothers towards obstetric danger sign was not addressed. Objectives. To determine knowledge, attitude, health-seeking action towards obstetric danger signs, and associated factors among postpartum women. Methods.A community-based cross-sectional study was conducted in Nekemte Town from October 1 to November 30, 2017. Multistage sampling technique was employed to select the total sample size of 621. Ethical clearance was obtained from Wollega University research and ethical committee. A pretested structured questionnaire was used to collect data from respondents. Data were entered to EpiData version 3.1 and exported to SPSS version 20 for analysis. To assess the associations between dependent and independent variables, binary and multivariate logistic regressions were employed, and the strength of association was presented using odds ratios with 95% confidence intervals. Result. Only 197 (32.3%) of respondents were able to spontaneously mention at least five key obstetric danger signs during antepartum, intrapartum, and postpartum (in the three phases) with at least one obstetric danger sign in each phase and thus were considered as having good knowledge of key obstetric danger signs. Government employee (AOR = 3.28, 95% CI: 1.98–5.42), able to read and write (AOR = 4.92, 95% CI: 2.14–11.3), primary school (AOR = 4.90, 95% CI: 2.11–11.4), ANC follow-up (AOR = 6.2, 95% CI: 1.82–21.21), and ANC visit (AOR = 4.07, 95% CI: 2.35–7.06) were significantly associated with knowledge of obstetric danger sign. From 150 (24.6%) participants who faced obstetric danger signs during their last pregnancy, the majority of them, 137 (91.3%), had a good practice which is seeking a health facility for care. Conclusion and Recommendation. Despite their low knowledge level and attitude, the practice of mothers in response to obstetric danger signs was encouraging. Occupation, educational status, ANC follow-up, and number of ANC visits were variables significantly associated with knowledge of obstetric danger signs. Health care providers should provide health education and counseling to increase awareness, and appropriate counseling during antenatal care at each visit is of paramount importance.

Assessment of knowledge of obstetric danger signs and its associated factors among pregnant women attending antenatal clinic of rural health training centre of a medical college: A cross-sectional study from Rajasthan

“…This was in line with the findings of a study done by Abdi. [ 24 ] Similar findings were noted by Wassihun et al ,[ 19 ] Regasa et al ,[ 21 ] and Liben et al . [ 25 ] Educated women were more likely to have a better understanding of the information they receive through various media.…”

“…[ 20 ] Several other studies had shown to vary the proportion of women having good knowledge about danger signs between 32% and 66%. [ 19 21 22 23 ] This difference in the knowledge of danger signs could be attributed to variation in terms of socio-demographic and geographical characteristics, health services coverage, and difference in the sampling technique.…”

Knowledge regarding obstetric danger signs among pregnant women

“…2 It was noted that almost 80% of maternal deaths occur due to direct obstetric complications including severe haemorrhage, pregnancy-induced hypertension, infections, and obstructed and prolonged labour. 3 According to Nepal Demographic and Health Survey (NDHS) 2016, the maternal mortality ratio (MMR) for Nepal is 239 deaths per 100,000 live births. 4 The Sustainable Development Goals (SDG) also speak the interrelationship of maternal and neonatal health with other aspects of development.…”

Women’s Knowledge and Attitudes about Complications during Pregnancy and Childbirth in Guinea

“…Studies in Egypt and Ghana also reported that the vast majority of women consulted a health provider when faced with danger signs or complications [4] [21]. The use of traditional birth attendants was cited by a minority of our participants and by other authors [17].…”

“…In addition, prolonged labor [15] [17] and intrauterine fetal death [13] are also listed. Further, high frequencies of headache and fever have also been reported by some authors [10] [14] [17] as well as premature rupture of membranes [18].…”