A protocol for a systematic review of birth preparedness and complication readiness programs

Systematic Reviews 02/2013; 2(1):11. DOI: 10.1186/2046-4053-2-11
Source: PubMed


One of the effective strategies for reducing the number of maternal deaths is delivery by a skilled birth attendant. Low utilization of skilled birth attendants has been attributed to delay in seeking care, delay in reaching a health facility and delay in receiving adequate care. Health workers could play a role in helping women prepare for birth and anticipate complications, in order to reduce delays. There is little evidence to support these birth preparedness and complication readiness (BP/CR) programs; however, BP/CR programs are frequently implemented. The objective of this review is to assess the effect of BP/CR programs on increasing skilled birth attendance in low-resource settings.
Due to the complexity of BP/CR programs and the need to understand why certain programs are more effective than others, we will combine both quantitative and qualitative studies in this systematic review. Search terms were selected with the assistance of a health information specialist. Three reviewers will independently select and assess studies for quality. Data will be extracted by one reviewer and checked for accuracy and completeness by a second reviewer. Discussion between the reviewers will resolve disagreements. If disagreements remain, a third party will be consulted. Data analysis will be carried out in accordance with the BP/CR matrix, developed by the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO). Study data will be grouped and analyzed by quality and study design and regrouped according to type of intervention strategy.
This review will provide: 1) an insight into existing BP/CR programs, 2) recommendations on effective elements of the different approaches, 3) proposals for concrete action plans for health professionals in the field of reproductive health in resource-poor settings and 4) an overview of existing knowledge gaps requiring further research.
Trial registration
PROSPERO registration no.: CRD42012003124

Download full-text


Available from: Jelle Stekelenburg

  • No preview · Article · Feb 2013 · Journal of midwifery & women's health
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: to assess birth preparedness in expectant mothers and to evaluate its association with skilled attendance at birth in central Nepal. DESIGN: a community-based prospective cohort study using structured questionnaires. SETTING: Kaski district of Nepal. PARTICIPANTS: a total of 701 pregnant women of more than 5 months gestation were recruited and interviewed, followed by a second interview within 45 days of delivery. MEASUREMENTS: outcome was skilled attendance at birth. Birth preparedness was measured by five indicators: identification of delivery place, identification of transport, identification of blood donor, money saving and antenatal care check-up. FINDINGS: level of birth preparedness was high with 65% of the women reported preparing for at least 4 of the 5 arrangements. It appears that the more arrangements made, the more likely were the women to have skilled attendance at birth (OR=1.51, p<0.001). For those pregnant women who intended to save money, identified a delivery place or identified a potential blood donor, their likelihood of actual delivery at a health facility increased by two to three fold. However, making arrangements for transportation and antenatal care check-up were not significantly associated with skilled attendance at birth. CONCLUSIONS: intention to deliver in a health-care facility as measured by birth preparedness indicators was associated with actual skilled attendance at birth. Birth preparedness packages could increase the proportion of skilled attendance at birth in the pathway of meeting the Millennium Development Goal 5.
    No preview · Article · Jun 2013 · Midwifery
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT This article presents findings from a study on women's delivery care-seeking in two regions of Guinea. We explored exposure to interventions promoting birth preparedness and complication readiness among women with recent live births and stillbirths. Using multivariate regression models, we identified factors associated with women's knowledge and practices related to birth preparedness, as well as their use of health facilities during childbirth. We found that women's knowledge about preparations for any birth (normal or complicated) was positively associated with increased preparation for birth, which itself was associated with institutional delivery. Knowledge about complication readiness, obstetric risks, and danger signs was not associated with birth preparation or with institutional delivery. The study findings highlight the importance of focusing on preparation for all births-and not simply obstetric emergencies-in interventions aimed at increasing women's use of skilled maternity care.
    Full-text · Article · May 2014 · Health Care For Women International
Show more