Birth Preparedness for Safe Delivery, Readiness Planning and Associated Factors among Mothers in North India: A Cross-Sectional Study in Bihar India

Abstract

Background: Birth Preparedness and complication readiness (BPCR) is a comprehensive strategy to improve the use of skilled providers at birth, based on the theory that helps women to consider all available maternal health care services during pregnancy and prepare for potential complications. Even though there are no adequate evidences on determinant factors, women and new-born need timely access to skilled care during pregnancy, childbirth, and the postpartum period. This paper aims to identify factors associated with the practice of birth preparedness and complication readiness plan among women in Bihar. Objectives: The objectives of the study were to assess the knowledge and practices regarding birth preparedness for safe delivery; and to identify the triggers and barriers for the program intervention activities. Study Design: Study design includes a cross sectional survey among the various categories of respondents including the mothers. A multi-staged cluster sampling approach used, sample size of 7646 respondents spread across 200 primary sampling units (PSUs) from Bihar, India. Methods: Community-based cross-sectional study was conducted. Pregnant women, mothers of children and mother in laws of respondents were randomly selected and interviewed using pretested structured questionnaire. The data was collected using CAPI questionnaire and analysed using SPSS. Descriptive statistics were reported, and bivariate and multivariable logistic regression carried out to see the effect of each independent variable on the dependent variable. Results: The study reveals that the awareness on danger signs of pregnancy, when to start planning for the delivery is fairly low. The knowledge to keep the important information that might be required in emergency viz. phone numbers of frontline worker ASHA handy has been found to be minimal. The key influencer within the family i.e. respondents’ mothers-in-law who are also the main source of information have poor awareness on birth preparedness. The interactions with the frontline workers are low. Timely identification and registration of pregnancy with ASHA and seeking information on birth planning act as triggers for birth preparedness. Conclusions: The program interventions are required to improve awareness about birth preparedness including emergency preparedness, danger signs during pregnancy, across all the mothers, more particularly socially marginalized groups. There is a need to mobilize the frontline workers and increase the interaction between the beneficiaries and FLWs to clarify the benefits of preparing for the delivery in advance.