title: Birth-preparedness for maternal health: findings from Koupéla District, Burkina Faso.
abstract: Maternal mortality is a global burden, with more than 500,000 women dying each year due to pregnancy and childbirth-related complications. Birth-preparedness and complication readiness is a comprehensive strategy to improve the use of skilled providers at birth, the key intervention to decrease maternal mortality. Birth-preparedness and complication readiness include many elements, including: (a) knowledge of danger signs; (b) plan for where to give birth; (c) plan for a birth attendant; (d) plan for transportation; and (e) plan for saving money. The 2003 Burkina Faso Demographic and Health Survey indicated that only 38.5% of women gave birth with the assistance of a skilled provider. The Maternal and Neonatal Health Program of JHPIEGO implemented a district-based model service-delivery system in Koupéla, Burkina Faso, during 2001-2004, to increase the use of skilled providers during pregnancy and childbirth. In 2004, a cross-sectional survey with a random sample of respondents was conducted to measure the impact of birth-preparedness and complication readiness on the use of skilled providers at birth. Of the 180 women who had given birth within 12 months of the survey, 46.1% had a plan for transportation, and 83.3% had a plan to save money. Women with these plans were more likely to give birth with the assistance of a skilled provider (p=0.07 and p=0.03 respectively). Controlling for education, parity, average distance to health facility, and the number of antenatal care visits, planning to save money was associated with giving birth with the assistance of a skilled provider (p=0.05). Qualitative interviews with women who had given birth within 12 months of the survey (n=30) support these findings. Most women saved money for delivery, but had less concrete plans for transportation. These findings highlight how birth-preparedness and complication readiness may be useful in increasing the use of skilled providers at birth, especially for women with a plan for saving money during pregnancy.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. allisyn@icddrb.org
authors.forename: Allisyn C
authors.initials: AC
authors.lastname: Moran
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sangli
authors.forename: Rebecca
authors.initials: R
authors.lastname: Dineen
authors.forename: Barbara
authors.initials: B
authors.lastname: Rawlins
authors.forename: Mathias
authors.initials: M
authors.lastname: Yaméogo
authors.forename: Banza
authors.initials: B
authors.lastname: Baya
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso; D016000:Cluster Analysis; D003153:Community Health Services / Q000379:methods* / Q000592:standards; D005260:Female; D006285:Health Planning / Q000379:methods*; D006293:Health Promotion; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008427:Maternal Health Services / Q000379:methods* / Q000592:standards; D008428:Maternal Mortality; D008880:Midwifery / Q000379:methods / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D014186:Transportation