title: Factors affecting birth preparedness and complication readiness in Jimma Zone, Southwest Ethiopia: a multilevel analysis.
abstract: BACKGROUND
  Birth preparedness and complication readiness have been considered as comprehensive strategy aimed at promoting the timely utilization of skilled maternal health care. However, its status and affecting factors have not been well studied at different levels in the study area. Thus, this study was aimed to fill this gap by conducting community based study.
  
  
  METHODS
  A cross-sectional study was conducted among randomly selected 3612 pregnant women from June-September 2012. The data were collected by interviewer-administered structured questionnaire and analyzed by SPSS V.20.0 and STATA 13. Mixed-effects multilevel logistic regression model was used to identify factors affecting birth preparedness and complication readiness.
  
  
  RESULTS
  The status of birth preparedness and complication readiness was 23.3% (95% CI: 21.8%, 24.9%). Being in urban residence and having health center within two hours distance were among the higher level factors increasing birth preparedness and complication readiness. Educational status of primary or above, husband's occupation of employed or merchant, third or above wealth quintiles, knowledge of key danger signs during labor, attitude and frequency of antenatal care visits were among the lower level factors found to increase the likelihood of preparation for birth and its complications.
  
  
  CONCLUSIONS
  The status of birth preparedness and complication readiness was low in the study area. Both community level and individual level factors had important program implications. Socio demographic, economic, knowledge of key danger signs, attitude and antenatal care use were identified as associated factors. Improving antenatal care, giving special emphasis to danger signs and community based health education are recommended.
authors: Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors: Gurmesa Tura
authors: GT
authors: Debelew
authors: Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors: Mesganaw Fantahun
authors: MF
authors: Afework
authors: Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors: Alemayehu Worku
authors: AW
authors: Yalew
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000523:psychology*; D005002:Ethiopia; D005260:Female; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Birth preparedness; Southwest Ethiopia; complication readiness; multilevel analysis