Menu
Menu
Menu
Menu
Introduction The knowledge of women about obstetric complications can helps them to seek health care earlier before obstetric complications arise. Most maternal deaths occur due to the poor health care seeking behavior after childbirth, but little is done on maternal knowledge of postpartum complications. Therefore this study aimed to assess knowledge of postpartum complications and associated factors among women who gave birth in the last 12 months in Arba Minch Town, Sothern Ethiopia. Methods A community-based cross-sectional study was conducted on 418 women from December 01 to 15, 2019. A multi-stage sampling method was applied to reach study units. A semistructured questionnaire was used to collect the data using face-to-face interviews. Bivariable and multivariable logistic regression was applied to examine the relationship between dependent and independent variables. Statistical significance was declared at a P-value ≤ 0.05 with the corresponding 95% confidence level. Results Knowledge of women on postpartum complications was 23.9%. Secondary and above educational level (AOR = 3.82, 95% CI: [1.70, 8.65]), Grand multiparity (AOR = 2.31, 95% CI: [1.13, 4.71]), having four and above ANC visit (AOR = 2.04, 95% CI: [1.10, 3.81]) and selfdecision making power to seek care (AOR = 3.68, 95% CI: [2.21, 6.11]) were statistically significant factors. Conclusion and recommendation Mothers’ knowledge of postpartum complications was low in this study area. Improving women’s educational level, decision-making power to seek health care, and counseling during ANC follow-up may be useful approaches to increase their knowledge of postpartum complications.
The study was conducted from 1st December to 15th December 2019 in Arba Minch town. Arba Minch is the administrative town of Gamo Zone, South Nation Nationality People Region (SNNPR), and Ethiopia. It is found at an elevation of 1285 meters above sea level and is located 505 km away from Addis Ababa, the capital city of Ethiopia. People with different ethnic groups and religions reside in the town. The town is divided into four sub-cities, namely, Abaya, Sikela, Nech-Sar & Shecha. The town consists of 11 kebeles (the smallest administrative unit) with a total population of 112, 724. There are 26, 265 reproductive age group (15–49) women who reside in the town out of which 4428 were pregnant. The total number of mothers who gave birth at the facility preceding the study period was 3992. There is one governmental General Hospital, two Health Centers, 17 primary care clinics, and 14 medium-sized private clinics in the town [12]. A community-based cross-sectional study. All women who gave birth in the last 12 months before the start of the study and lived in Arba Minch town for six months were chosen. Individual mothers were systematically selected and interviewed in four randomly selected kebeles, with a total of 1475 mothers eligible for the study sample allocation. Mothers who were critically ill and unable to participate in the interviews were excluded from the study. As a result, the study included those mothers who had given birth within the previous year before the study period. The sample size was calculated by using a single population proportion formula with the assumption of, a 95% confidence level, 5% margin of error, 5% non-response rate, 1.5 design effect, and expected population proportion of mothers who were knowledgeable about postpartum complications was 22.1% [13]. Where, n = sample size Z = standard normal distribution value at 95% confidence level of ∝2 = 1.96 P = women’s knowledge of postpartum complications = 22.1% [13]. d = margin of error = 5% n = 265 Based on the assumptions the final calculated sample was: n = 418 Arba Minch town was purposively selected as a study area. The study participants were chosen using a multistage sampling process. There were 11 kebeles in the town, so kebeles were divided into 11 clusters. Using a simple random sampling procedure, four kebeles (Bere, Ediget-Ber, Wuha-Minch, and Dilfana) were chosen, and mothers who gave birth in the previous 12 months in each kebele were identified by contacting kebele health extension workers (HEW) for the updated register. The overall number of mothers who gave birth in the four kebeles was N (estimated total number of deliveries in four kebeles) 1475 (Bere = 331, Ediget-ber = 471, Wuha-Minch = 371 & Dilfana = 302 ladies). Using a proportional allocation formula, the sample assigned to a specific kebele was considered. The calculated samples for Bere, Ediget Bere, Wuha Minch, and Dilfana were 94, 133, 105, and 86 mothers, respectively, based on the proportion to size allocation. The ’K’-value was calculated by dividing the number of mothers who gave birth in the previous 12 months in each selected kebele by the sample allocated to that kebele, yielding the following results: 3.52, 3.54, 3.53, and 3.51 for Bere, Ediget Ber, Wuha Minch, and Dilfana, respectively. By chance, the rounded k-value of all of the chosen kebeles was 3. The first mother was discovered by randomly selecting one household on the kebele’s outskirts with the assistance of HEW and the leaders of specific kebeles. Then, for every three mothers, a systematic random sampling technique was used to obtain study participants, which was repeated until the sample was complete. If more than one mother was found in a single household using the lottery method, only one mother was chosen. The data were collected by face-to-face interviews using a semi-structured questionnaire. The questionnaire was adapted from previously approved types of literature considering the study objectives [17, 18]. It consists of socio-demographic variables, obstetric factors, and postpartum complications knowledge measuring questions. The questionnaire was prepared in English and was translated to Amharic (working language of the study area) and then, back to English for consistency. Three female diploma midwives who are fluent in speaking the Amharic language were involved in data collection. Two males who have Bachelors of Science degrees in midwifery’ health professionals were recruited as supervisors. Women’s knowledge of postpartum complications. Socio-demographic variables. Maternal age, marital status, occupational status, educational status, monthly income & access to media. Obstetric factors & health service use. Parity, Antenatal care visit, information on the pregnancy-related problem, place of delivery, self-decision making autonomy to seek health care. Mothers who spontaneously mentioned three and above postpartum complications were declared as knowledgeable about postpartum complications [13, 14]. The quality of the data was maintained before, during, and after data collection. A semi-structured questionnaire was adapted from different types of previously published literature. Then pretesting of the questionnaire was carried out on 5% of the sample that was, on 21 mothers in Mirab Abaya town, Gamo Zone, Ethiopia, and any necessary amendments were done. Intensive training of three days duration about the objective of the study, questionnaire, and ethical issues was given to data collectors and supervisors. During the data collection period, questionnaires were checked for completeness and consistency immediately by data collectors. After data collection, the principal investigator and supervisors rechecked the collected data for its completeness, and corrective measures were taken accordingly. Then, data was entered to epi info version 3.5.1 and 5% of the data set was double entered to check the accuracy of the entered data. After data collection was complete, each questionnaire was coded and entered into Epi info version 3.5.1 and then, it was exported to SPSS Version 20 window compatible software for cleaning and analysis. By using simple frequency tables and cross-tabulation data were checked for completeness. A descriptive statistical method such as frequency tables, graphs, and mean with standard deviation was used to present different characteristics of study participants. Bivariable logistic regression was done and variables with P-value ≤ 0.25 and all other variables that had an association in previously approved kinds of literature and assumed to have scientific relevance to the study were selected as candidate variables for multivariable logistic regression analysis to control the effect of confounders. A backward stepwise logistic regression method was used for the analysis. Model fitness was checked by Hosmer and Lemeshow’s goodness of model fit test (P = 0.434). Finally adjusted odds ratio with corresponding 95% CI and p-value ≤ 0.05 was taken as a statistical association between the dependent and independent variables. Ethical approval for the study was obtained from Arba Minch University, College of Medicine and Health Sciences Institutional Research Review Board (IRB/132/12 dated December 27, 2019). A formal letter of permission to conduct the study was obtained from Gamo Zone Health Department, Arba Minch Town Health Office. The verbal consensus was made with mothers after an explanation of the purpose of the study, and the part they took in the research by data collectors to assure their right to refuse or participate in the study. Mothers were also told that the data obtained will be kept confidential & had the right to withdraw from the study at any time during the interview.
