ABSTRACT
Background: Maternal mortality
is an enormous public health burden in developing countries of the
world. Birth preparedness and emergency readiness is the process of planning
for safe delivery and anticipating the actions needed in case of emergencies.
When a woman is adequately prepared for normal childbirth and possible
complications, she is more likely to access the skilled and prompt care she
needs to protect her overall health and possibly save her life and that of her
baby. This descriptive study assessed the birth preparedness and emergency
readiness of antenatal clinic attendees in a secondary health facility in Awka,
South eastern Nigeria.
Methodology: This
is a cross-sectional descriptive study carried out among pregnant women
attending antenatal clinic at Amaku General Hospital Awka.
The data was collected from the pregnant women using semi-structured
interviewer administered questionnaire.
Findings: The
mean age of the respondents was 27.9 years with a standard deviation of
4.5 years. The proportion of the respondents who were birth prepared was 56% as
against 6% who were emergency ready. Up to 59.8% of the respondents of
gestational age >=20weeks were birth prepared compared to 12.5% of the
respondents of gestational age <20weeks 12="" 25="" 26="" 3="" 46.9="" 67.9="" 84="" 85="" 97="" a="" and="" as="" at="" birth="" but="" compared="" completely="" danger="" drugs="" equal="" four="" greater="" had="" ignorant="" in="" knew="" labour="" least="" more="" much="" name="page13" of="" on="" one="" only="" or="" p="0.011)." parity="" post-partum="" pregnancy="" prepared="" primiparous="" received="" respondents="" routine="" sign="" signs.="" tetanus="" than="" the="" three="" to="" toxoid="" were="" whereas="" while="" who="">
malaria prophylaxis (intermittent preventive
treatment with sulphadoxine and pyrimethamin IPTsp).
Conclusion: Most
pregnant women make arrangements in anticipation of normal delivery but
the same cannot be said for emergencies.
CHAPTER ONE
1.0 INTRODUCTION
Pregnancy is the physical condition of a woman carrying
unborn offspring inside her body, from fertilization to birth. Child birth is
the process of having a baby emerge from the womb. Pregnancy and child birth,
under normal conditions is not a disease but a physiological process.1 It
is a blessing and a thing of joy. There is, therefore, no need for any woman to
die as a result of pregnancy or child birth.1 Unfortunately, many women in
developing countries of the world face increased risk of morbidity and
mortality from pregnancy and other pregnancy related issues. 1
Birth preparedness and emergency readiness involves active,
definite preparation and decisions made by a pregnant woman for birthing
including arrangements made for emergencies that may arise at any time in
pregnancy, during delivery or after delivery.2 This planning has the
potential to reduce morbidity and mortality during pregnancy, delivery and
post-partum by ensuring faster access to care.2
Birth preparedness and emergency readiness is also a
comprehensive strategy to improve the use of skilled providers at birth, the
key intervention to decrease maternal mortality.3 The concept of birth
preparedness and emergency readiness includes the following elements: (a)
knowledge of danger signs; (b) plan for where to give birth; (c) plan for a
birth attendant; (d) plan for transportation; (e) plan for saving money; and
(f) identifying a blood donor in case of an obstetric emergency. 4
Birth preparedness and emergency readiness is therefore a key
strategy in safe motherhood programmes, a global effort that aims to reduce
deaths and illnesses among women especially in developing countries. 5,6
Specifically aimed at reducing maternal mortality, these programmes are being
developed in the wider context of health services for women’s
reproductive health. 6
According to the World Health Organisation (WHO), maternal
death is the death of a woman while pregnant or within 42 days of termination
of pregnancy, irrespective of the duration and site of the pregnancy, from any
cause related to or aggravated by the pregnancy or its management but not from accidental or
incidental causes.7 As stated
by the 2005 WHO
report 5
“Make Every Mother And Child Count”
the major causes of maternal death are: severe bleeding/haemorrhage (25%),
infections (13%), unsafe abortions (13%), eclampsia (12%), obstructed labour
(8%), other direct causes (8%), and indirect causes (20%) 7.
Indirect causes such as malaria,
anaemia, HIV/AIDS and cardiovascular disease, complicate pregnancy or are
aggravated by it. 7
1.1 STATEMENT OF
THE PROBLEM
Maternal mortality is a substantial public health burden in
developing countries. The World Health Organisation estimates that
approximately 536,000 women die from pregnancy and childbirth-related
complications each year with 95% of these deaths occurring in sub-Saharan Africa and Asia.8
Africa has the highest burden of maternal mortality in the world and sub-Saharan
Africa is largely responsible for the dismal maternal death figure for that
region, contributing approximately 98% of the maternal deaths for the
region.8 The lifetime risk of maternal death in sub-Saharan Africa is 1 in 22
mothers compared to 1 in 210 in Northern Africa, 1 in 62 for Oceania, 1 in 120
for Asia, 1 in 290 for Latin America and the Caribbean, and 1 in 29,800 for Sweden.8
Nigeria is a leading contributor to the maternal death figure
in sub-Saharan Africa, not only because of the hugeness of her population but
also because of her high maternal mortality ratio. Nigeria has a maternal
mortality ratio of 545 per 100,000.9 With an estimated 59,000 maternal deaths
annually, Nigeria which has approximately 2% of the world’s population
contributes 10% of the world’s maternal deaths.10
The only country that has a higher absolute number of maternal deaths is India, with 136,000 maternal deaths
each year. 11 Maternal mortality ratios in Nigeria vary considerably between
various states in the country and between rural and urban areas. It is
considerably higher in rural than urban areas and worse in the Northeast and
Northwest geopolitical zones than in the Southwest and Southeast zones. 12
Maternal morbidity, defined as chronic and persistent ill
health occurring due to complications of pregnancy, labour, delivery, and
postpartum ,11 is an important indicator of maternal health. Available evidence
indicates that for every woman who dies during childbirth in Nigeria, another
30 suffer short and long-term disabilities, 11 such as chronic anaemia, maternal exhaustion
or physical weakness; obstetric fistula,
stress incontinence; chronic
pelvic pain, pelvic inflammatory
disease, infertility, ectopic
pregnancy; and emotional 7 depression etc. UNFPA estimates that
2 million women are affected by obstetric fistula in the developing world, out
of which 800,000 (40%) occur in Nigeria, particularly in the north. 13
The tragic issue of maternal deaths has received global
attention and different strategies have been designed for its reduction to date.14
The Safe Motherhood initiative was launched in Nairobi Kenya in 1987. In 1990,
Safe Motherhood conference took place in Abuja , Nigeria. Another Safe
Motherhood conference took place in Colombo, Sri Lanka in 1997. In 1998 the
World Health Day theme was: “ Pregnancy is Special: Let us Make it Safe”. Still
in an attempt to address the issue of maternal deaths, the UN General Assembly,
in 1999, recommended increasing the proportion of births assisted by Health
Professionals to 80%. The magnitude, developmental and Human Rights nature of
the issue gave it prominence at the United Nations summit in 2000 where one of
the three health-related Millennium Development Goals (MDGs) was devoted to reducing, by 75%, maternal mortality rate by 2015.
14,15
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Item Type: Project Material | Size: 73 pages | Chapters: 1-5
Format: MS Word | Delivery: Within 30Mins.
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