Assessment of Knowledge of Obstetric Danger Signs and Its Associated Factors Among Pregnant Women Attending Antenatal Clinic at Pumwani Maternity Hospital.

Abstract

Study Background High death rate of pregnant women especially in developing countries has created the need for the improvement of the process of pregnancy danger signs’ awareness as a method to enhance uptake of skilled maternal care. In Kenya, the outcome of the awareness has been the reduction of maternal mortality to 362 deaths. However, this is still not close to the SDG target 3.1 of reducing global maternal mortality ratio to less than 70 per 100,000 live births. Despite the emphasis on increased awareness of pregnancy warning signals as is required to reach the national goal, less information is present concerning the true level of knowledge in Kenya today. Broad Objective To discern the level of awareness on danger inferring obstetric signs and its related factors in pregnant mothers getting antenatal clinic services at Pumwani Maternity Hospital. Methods A cross-sectional study was conducted from 1st September 202 to 30th September 2022 on randomly selected sample of 375 pregnant women who were attending ANC clinic at Pumwani maternity Hospital. Pre-tested structured questionnaire was used to collect data on the women who and consented. Chi-squares and logistic regression analysis were performed using STATA version 11.2 and results were presented using tables and graphs. Results Total of 371 pregnant women accurately filled the questionnaire making a response rate of 97.87%. The most common mentioned danger sign during pregnancy was severe headache by 269(71.7%) Women who could mention atleast 3 danger signs during childbirth and postpartum period were 174(46%) and 168(45%) respectively.Occupation (Chi Square = 16.182 df= 4, χ2= 0.0.003) and access to cost of ANC care (Chi Square = 6.6017 df= 2 , χ2= 0.037)were factors found to be significantly associated with knowledge of danger signs during pregnancy. The study findings also indicated significance association in marital status (.Chi Square = 8.9735 df= 2, χ2= 0.011), occupation (Chi Square = 20.970 df= 4, χ2= 0.0.000) and income and access to cost of reading/listening materials (Chi Square = 33.8285 df= 20, χ2= 0.027) with knowledge in labor. Cost of antenatal care (Chi Square = 9.5098 df= 2, χ2= 0.009) and access to cost of

reading/listening materials (Chi Square = 34.1152 df= 20, χ2= 0.025) were found to be significantly associated with knowledge during postpartum. Pregnant women in Week 28 -42 have 0.872 chance of having knowledge in pregnancy danger signs, 2.054 chance of having knowledge of labour danger signs and 2.340 chance of knowledge of post-partum danger signs compared to those in week 1-13 of gestation. women with gravidity of 4 and above, they are 3.214 times more likely to have knowledge of pregnancy danger signs, 1.345 times more likely to have knowledge of labour danger signs and 3.098 times more likely to have knowledge of post-partum danger signs compared to those of gravidity of 1. Conclusion The study concluded that the overall knowledge on obstetric danger signs is fair because most of the respondents were aware of three or more signs, with exposure to reading materials a key factor in the knowledge of danger signs in all three obstetric phases. However, the level of knowledge about postpartum danger signs was found lower compared to knowledge of danger signs during pregnancy and delivery indicating that women in the post-partum phase are likely to delay in seeking healthcare.