Strategies for improving birth preparedness among pregnant women attending antenatal care clinics at public healthcare facilities of Arsi zone in Oromia, Ethiopia

Abstract

The purpose of this study was to develop strategies for improving birth preparedness and complication readiness (BPCR) among pregnant women attending antenatal care (ANC) clinics at public health facilities of Arsi Zone in Oromia, Ethiopia. The findings of this study serve as a guide to develop strategies to improve BPCR and reduce maternal and neonatal morbidities and mortalities.

Setting: The study was conducted at five public health facilities in Arsi Zone, Oromia, Ethiopia.

Study population and sample: The population for this study consisted of pregnant women attending ANC clinics, as well as health professionals (key informants) in selected public health facilities. In the quantitative part of the study, a systematic random sampling technique was used to select 1 014 pregnant women, whereas in the qualitative part, purposive sampling was used to select 36 pregnant women for three focus group discussions and 9 health professionals were selected for key informant in-depth interviews.

Study design: A sequential explanatory mixed methods approach was applied.

Data collection and data analysis methods: A sequential explanatory mixed method was employed. Accordingly, a questionnaire was used to collect data from 1 014 pregnant women. The data was collected from January to February 2022. The quantitative data was entered into Epi info version 3.5.4 and transferred to SPSS version 26 for further cleaning and analysis of the results. Three focus groups and nine key informant interviews were conducted using an interview guide. ATLAS.ti version 8 was used for further analysis of qualitative data.

Result: In this study, of the 1 014 pregnant women, 772 (76.1%) were aware of BPCR, 869 (85.7%) were prepared for birth for their current pregnancy, 634 (72.9%) had iv identified the place of birth, 330 (38.9%) had saved money for emergencies and 156 (18%) had identified skilled birth attendants to provide care during birth. Among the predictor variables, the age of the pregnant women, pregnant women who had mobile phones and pregnant women who had their husband's support were some of the variables significantly associated with the use of BPCR. The quantitative findings were supported by the focus groups and key informant interviews. The themes from the focus groups with pregnant women and interviews with health professionals included the opinions and perceptions of the pregnant women and the understanding of health professionals regarding BPCR. The level of BPCR in pregnant women for the major components of BPCR in this study is low. The Ministry of Health, the regional health office, the district health office, the health facility, and the health professionals need to increase awareness among pregnant women about BPCR.

Inhloso yalolu cwaningo ukuthi kusungulwe amasu okwenza ngcono indlela yokulungiselela nokumelana nokuphambana kwezinto ngesikhathi sokubeletha (BPCR) kwabesifazane abakhulelwe abahambela imitholampilo yokunakekelwa kwabakhulelwe (ANC) emitholampilo kahulumeni e-Arsi Zone e-Oromia, ezweni laseTopiya. Okutholwe kulolu cwaningo kusebenza njengomhlahlandlela wokusungulwa kwamasu okwenza ngcono i-BPCR nokunciphisa ukugula nokushona komama kanye nezinsana ezizelwe. Ukulungiselela: Lolu cwaningo lwenziwe ezikhungweni zezempilo zikahulumeni ezinhlanu ezise-Arsi Zone, e-Oromia, ezweni laseTopiya. Inani labantu namasampula ocwaningo: Inani labantu okwenziwe ngabo lolu cwaningo belihlanganisa abesifazane abakhulelwe abahambela imitholampilo ye-ANC, kanye nabasebenzi bezempilo (abanolwazi olunzulu) ezikhungweni zezempilo zikahulumeni ezikhethiwe. Engxenyeni yocwaningo lwamanani, kusetshenziswe uhlelo lwamasampula aqoqwe ngokungazelele kwakhethwa abesifazane abakhulelwe abayi-1 014, kanti engxenyeni yocwaningo lwamaqophelo khona, kusetshenziswe amasampula okucacisa inhloso kwakhethwa abesifazane abakhulelwe abangama-36 ngokwamaqoqo amathathu okuxoxiswane nawo kwase kukhethwa nabasebenzi bezempilo abayisi-9 ukuze kutholakale ulwazi olunzulu ngokwezingxoxo ezijulile ezibanjiwe. Ukuhleleka kocwaningo: Kusetshenziswe izinhlelo ezixubile ezilandisa ngokulandelana. Izindlela zokuqoqwa nokucwaningwa kwemininingwane: Kusetshenziswe izinhlelo ezixubile ezilandisa ngokulandelana. Ngokuvumelana nalokho, kusetshenziswe uhlu lwemibuzo ukuze kuqoqwe imininingwane kwabesifazane abakhulelwe abayi-1 014. Le mininingwane iqoqwe kusukela ngoMasingana kuya kuNhlolanja 2022. Imininingwane yamanani ithathwe yafakwa ku-Epi info version 3.5.4 yase idluliselwa ku-SPSS version 26 ukuze kuhlelwe futhi kucwaningwe kahle imiphumela. Lapha kuxoxiswane namaqoqo amathathu kwabanjwa izingxoxo ezinzulu eziyisishiyagalolunye kusetshenziswa umhlahlandlela wokuxoxisana. Kuphinde kwasetshenziswa i-ATLAS.ti version 8 ukuze kucwaningwe kabanzi imininingwane yokuhlolwa kwamaqophelo. Umphumela: Kulolu cwaningo, kutholakale ukuthi kwabesifazane abakhulelwe abayi-1 014, abangama-772 (76.1%) babo bayazi nge-BPCR, abangama-869 (85.7%) bona bebekulungiselele ukubeletha ngesikhathi sokukhulelwa kwabo, abangama-634 (72.9%) babo bebeyihlonzile indawo yokubelethela, kanti abangama-330 (38.9%) bazibekele imali yezimo eziphuthumayo bese kuthi abangu-156 (18%) bazihlonzele ababelethisi abanekhono ukuze banakekeleke ngesikhathi sokubeletha. Phakathi kokuguquguquka kwezinto ezibikezelayo, kubalwa iminyaka yobudala yabesifazane abakhulelwe, abesifazane abakhulelwe abanomakhalekhukhwini kanye nabesifazane abakhulelwe abasekelwa abayeni babo kungezinye zezinto ezihlobene kakhulu nokusebenza kwe-BPCR. Imiphumela yohlelo lokuhlolwa kwamanani yesekelwe yilawo maqoqo okuxoxiswane nawo kanye nezingxoxo ezijulile ezibanjiwe. Imiqondo etholakale kumaqoqo okuxoxiswane nawo ezinkulumweni nabesifazane abakhulelwe ngokunjalo nangokuxoxisana nabasebenzi bezempilo ibandakanya imibono nemicabango yabesifazane abakhulelwe kanjalo nokuqonda kwabasebenzi bezempilo mayelana ne-BPCR. Lolu cwaningo luveza ukuthi liphansi kakhulu izinga le-BPCR kwabesifazane abakhulelwe ezikhathini eziyingxenye enkulu maqondana nokuzilungiselela i-BPCR. UMnyango Wezempilo, ihhovisi lezempilo lendawo, ihhovisi lezempilo lesifunda, isikhungo sezempilo kanye nabasebenzi bezempilo kudingeka bandise izinhlelo zokuqwashisa abesifazane abakhulelwe ngokwe-BPCR.

Sepheo sa phuputso ena e ne e le ho hlahisa mekgwa ya ho ntlafatsa ho itokisetsa pelehi le ho itokisetsa mathata a pelehi (BPCR) hara baimana ba yang tlhokomelong ya boimana ya pele ho pelehi (ANC) ditleliniking tsa ditsi tsa bophelo bo botle tsa setjhaba tsa sebaka sa Arsi Zone, Oromia, Ethiopia. Diphumano tsa phuputso ena di sebetsa e le tataiso ya ho hlahisa maano a ho ntlafatsa BPCR le ho fokotsa ho kula le mafu a baimana le masea. Tikoloho: Phuputso e etseditswe ditsing tse hlano tsa bophelo bo botle tsa setjhaba sebakeng sa Arsi Zone, Oromia, Ethiopia. Palo ya batho bao phuputso e etswang ho bona le sampole: Palo ya batho bao phuputso ena e etsetswang ho bona e ne e le ya baimana ba yang ditleleniking tsa ANC, hammoho le ditsebi tsa bophelo bo botle (bafani ba tlhahisoleseding ba ka sehloohong) ditsing tsa bophelo bo botle tse kgethilweng tsa setjhaba. Karolong ya dipalo tsa phuputso, ho ile ha sebediswa mokgwa o hlophisehileng wa ho etsa disampole ho kgetha baimana ba 1 014, athe karolong ya boleng, ho ile ha sebediswa disampole tse reretsweng ho kgetha baimana ba 36 bakeng sa dipuisano tsa dihlopha tse tharo mme ho ile ha kgethwa ditsebi tse 9 tsa bophelo bo botle bakeng sa batho ba fanang ka tlhahisoleseding ba dipuisano tse tebileng. Moralo wa phuputso: Ho sebedisitswe katamelo ya ho hlalosa ka tatellano wa mekgwa e tswakilweng. Pokello ya datha le mekgwa ya manollo ya datha: Ho ile ha sebediswa katamelo ya ho hlalosa ka tatellano wa mekgwa e tswakilweng. Ka hona, ho ile ha sebediswa lethathamo la dipotso ho bokella datha ho tswa ho baimana ba 1 014. Datha e bokelletswe ho tloha ka Pherekgong ho ya ho Hlakola 2022. Datha ya dipalo e kentswe ho mofuta wa Epi info 3.5.4 mme ya fetisetswa ho mofuta wa SPSS 26 bakeng sa ho hlwekiswa le manollo ya diphetho. Dihlopha tse tharo tseo ho shebanweng le tsona le dipuisano tsa batho ba robong ba fanang ka tlhahisoleseding ba ka sehloohong di entswe ho sebediswa tataiso ya dipuisano. Mofuta wa 8 wa ATLAS.ti o ile wa sebediswa bakeng sa tlhahlobo e tswelang pele ya datha ya boleng. Sephetho: Phuputsong ena, ho basadi ba 1 014 ba baimane, ba 772 (76.1%) ba ne ba tseba ka BPCR, ba 869 (85.7%) ba ne ba itokiseditse pelehi bakeng sa boimana ba bona ba hona jwale, ba 634 (72.9%) ba ne ba hlwaile sebaka sa tswalo, ba 330 (38.9%) ba ne ba bolokile tjhelete bakeng sa maemo a tshohanyetso mme ba 156 (18%) ba ne ba hlwaile bapepisi ba nang le tsebo ho fana ka tlhokomelo nakong ya pelehi. Hara dintho tse fapaneng tse tataisang, dilemo tsa baimana, baimana ba neng ba na le mehala ya thekeng le baimana ba neng ba na le tshehetso ya banna ba bona e ne e le dintho tse fapaneng tse amanang haholo le tshebediso ya BPCR. Diphumano tsa dipalo di ile tsa tshehetswa ke dihlopha tseo ho shebanweng le tsona le dipuisano tsa ditsebi tse ka sehloohong. Dihlooho tse tswang dihlopheng tseo ho shebanweng le tsona tsa basadi ba baimana le dipuisano le ditsebi tsa bophelo bo botle di ne di kenyelletsa maikutlo le mehopolo ya basadi ba baimana le kutlwisiso ya litsebi tsa bophelo bo botle mabapi le BPCR. Boemo ba BPCR basading ba baimana bakeng sa dikarolo tse kgolo tsa BPCR phuputsong ena bo tlase. Lekala la Bophelo bo botle, ofisi ya bophelo ya lebatowa, ofisi ya bophelo ya setereke, setsi sa bophelo bo botle le ditsebi tsa bophelo bo botle ba hloka ho lemosa baimana ka BPCR.