title: Knowledge of safe motherhood among women in rural communities in northern Nigeria: implications for maternal mortality reduction.
abstract: BACKGROUND
  Most developed countries have made considerable progress in addressing maternal mortality, but it appears that countries with high maternal mortality burdens like Nigeria have made little progress in improving maternal health outcomes despite emphasis by the Millennium Development Goals (MDGs). Knowledge about safe motherhood practices could help reduce pregnancy related health risks. This study examines knowledge of safe motherhood among women in selected rural communities in northern Nigeria.
  
  
  METHODS
  This was a cross-sectional study carried out in two states (Kaduna and Kano States) within northern Nigeria. Pretested, interviewer-administered questionnaires were applied by female data collectors to 540 randomly selected women who had recently delivered within the study site. Chi-square tests were used to determine possible association between variables during bivariate analysis. Variables significant in the bivariate analysis were subsequently entered into a multivariate logistic regression analysis. The degree of association was estimated by odds ratio (OR) and 95% confidence interval (CI) between knowledge of maternal danger signs and independent socio-demographic as well as obstetric history variables which indicated significance at p < 0.05.
  
  
  RESULTS
  Over 90% of respondents in both states showed poor knowledge of the benefits of health facility delivery by a skilled birth attendant. More than 80% of respondents in both states displayed poor knowledge of the benefits of ANC visits. More than half of the respondents across both states had poor knowledge of maternal danger signs. According to multivariate regression analysis, ever attending school by a respondent increased the likelihood of knowing maternal danger signs by threefold (OR 2.63, 95% CI: 1.2-5.8) among respondents in Kaduna State. While attendance at ANC visits during most recent pregnancy increased the likelihood of knowing maternal danger signs by twofold among respondents in Kano State (OR 2.05, 95% CI: 1.1-3.9) and threefold among respondents in Kaduna State (OR 3.33, 95% CI: 1.6-7.2).
  
  
  CONCLUSIONS
  This study found generally poor knowledge about safe motherhood practices among female respondents within selected rural communities in northern Nigeria. Knowledge of safe pregnancy practices among some women in rural communities is strongly associated with attendance at ANC visits, being employed or acquiring some level of education. Increasing knowledge about safe motherhood practices should translate into safer pregnancy outcomes and subsequently lead to lower maternal mortality across the developing world.
authors.affiliation: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. eokereke78@gmail.com.
authors.forename: Ekechi
authors.initials: E
authors.lastname: Okereke
authors.forename: Susan
authors.initials: S
authors.lastname: Aradeon
authors.forename: Adekunle
authors.initials: A
authors.lastname: Akerele
authors.forename: Mustapha
authors.initials: M
authors.lastname: Tanko
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yisa
authors.forename: Benson
authors.initials: B
authors.lastname: Obonyo
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data; D008428:Maternal Mortality; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012424:Rural Population