202101 Birth and newborn care preparedness enhances use of skilled birth attendant in rural Bangladesh

Wednesday, November 11, 2009: 1:15 PM

Mohammad Rasheduzzaman Shah , PROJAHNMO Study Group, PROJAHNMO - Sylhet, Sylhet, Bangladesh
Nazma Begum , Child Health Unit, Public Health Science Division, ICDDR,B, Dhaka, Bangladesh
Qazi Sadeq-ur Rahman , Child Health Unit, Public Health Science Division, ICDDR,B, Dhaka, Bangladesh
Shams El Arifeen , Child Health Unit, Public Health Science Division, ICDDR,B, Dhaka, Bangladesh
Syed Moshfiqur Rahman , Child Health Unit, Public Health Science Division, ICDDR,B, Dhaka, Bangladesh
Abdullah Baqui , International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Many community-based programs promote birth and newborn care preparedness (BNCP) to increase skilled attendance at delivery and to improve maternal and perinatal outcomes. However, evidence for birth and newborn care preparedness (BNCP) to enhance skilled care seeking at birth is scarce.

Objective: To examine the association between birth preparedness and use of a skilled birth attendant in a rural Bangladesh.

Methods: This analysis uses data from a community- based cluster randomized trial conducted during 2002-2006 in three rural sub-districts in Bangladesh. Female community health workers (CHWs) made home visits to promote BNCP and counseled pregnant women and their families on importance of maternal care and essential newborn care. They also counseled on four BNCP steps: 1) identifying a skilled or a trained delivery assistant, 2) identifying an immediate newborn care person, 3) arranging transport for emergency transfer, and 4) saving money for emergencies. Bivariate and multivariate methods were used to assess the association between taking any BNCP steps and using a skilled birth attendant.

Results: Of 6,652 women who delivered during 2004-2005, 45.5% (n=3,024) complied with at least one birth preparation step; Adjusted analysis revealed women who took at least one BNCP step were 78% more likely to have skilled care at birth [OR: 1.78; 95% CI: 1.36-2.34].

Conclusions: Although use of skilled attendant remained low, the strong association between BNCP practices and use of skilled attendant at delivery suggest that promotion of BNCP should be considered in the design of community based maternal and neonatal health programs.

Learning Objectives:
1. Analyze the association between birth preparedness and use of a skilled birth attendant in a rural community 2. Explain the potential benefit of birth and newborn care preparedness for promoting skilled attendance at birth at rural community

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Rashed Shah is a Master of Science in International Health from the University of Uppsala, Sweden and has a Bachelor’s degree in Medicine and Surgery (MBBS) from Dhaka Medical College, Bangladesh. He possesses strong academic record in research, health program management, and International Health. His professional area of interests includes maternal and child health, child survival and health program management. He has aptitudes in project design and coordination, research and documentation, policy advocacy, communication and networking, resource mobilization, training, and social/community mobilization. Dr. Rashed worked for CARE-Bangladesh, Save the Children (USA), ICDDR,B and currently is affiliated with the department of International Health of Bloomberg School of public health in Johns Hopkins University. His current responsibilities include overall filed management of the community-based program implementation of renowned newborn health research program named “PROJAHNMO” in Bangladesh. Dr. Rashed Shah, as a PROJAHNMO Study group, participated in presenting and disseminating study results in a number of meetings and conferences.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Birth practices and newborn feeding in developing countries
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