BIRTH PREPAREDNESS AND EMERGENCY READINESS PLANS OF ANTENATAL CLINIC ATTENDEES IN AMAKU GENERAL HOSPITAL AWKA, ANAMBRA STATE NIGERIA

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  |  Attribute: 73 pages  |  Chapters: 1-5
Format: MS Word  |  Price: N3,000  |  Delivery: Within 30Mins.
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