Pregnant women's knowledge of obstetrical danger signs: A cross-sectional survey in Kigali, Rwanda.

• Type of Material: Article
• Authors: Emmanuel Uwiringiyimana, University of Rwanda; Emery Manirambona, University of Rwanda; Samuel Byiringiro, John Hopkins University; Albert Nsanzimana, University of Rwanda; Neophyte Uhawenayo, University of Rwanda; Pacifique Ufitinema, University of Rwanda; Janviere Bayizere, University of Rwanda; Patricia Moreland, Emory University; Pamela Meharry, University of Illinois, Chicago; Diomede Ntasumbumuyange, University of Rwanda and Centre Hospitalier Universitaire de Kigali
• Language: English
• Date: 2022
• Publisher: PLOS
• Publication Version: Final Published Version
• Copyright Statement: © 2022 Uwiringiyimana et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pgph.0001084
• Title of Journal or Parent Work: PLOS Glob Public Health
• Volume: 2
• Issue: 11
• Start Page: e0001084
• End Page: e0001084
• Grant/Funding Information: The authors received no specific funding for this work.
• Keywords: Pregnant women; Maternal mortality
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Nursing; Health Sciences, Medicine and Surgery

Abstract

Maternal mortality remains critically high in low- and middle-income countries (LMIC), particularly in sub-Saharan Africa. Rwanda's leading causes of maternal death include postpartum hemorrhage and obstructed labor. Maternal recognition of obstetrical danger signs is critical for timely access to emergency care to reduce maternal mortality.To assess maternal knowledge of obstetrical danger signs among pregnant women attending antenatal care services in Kigali, Rwanda. We conducted a cross-sectional study between September and December 2018. The outcome of interest was maternal knowledge of ODS during pregnancy, labor and delivery, and the immediate postpartum period. We recruited pregnant women at five health centers, one district hospital, and one referral hospital, and we had them complete a structured questionnaire. Reporting three correct ODS was defined as having good knowledge of ODS. A total of 382 pregnant women responded to the survey. Most women (48.9%) were aged 26-35, and 50.5% had completed secondary or higher education. The knowledge of ODS was 56%, 9%, and 17% during pregnancy, labor and delivery, and postpartum, respectively. Women aged 26 to 35 had two times (OR: 1.80, 95% CI: 1.05, 3.06) higher odds of ODS knowledge during pregnancy than women aged 16 to 25. Attending three antenatal care visits was associated with 2.6 times (OR: 2.59, 95% CI: 1.17, 5.66) higher odds of ODS knowledge during pregnancy than not attending any visit. Longer distances to the nearby health facility were associated with significantly lower knowledge during pregnancy, and Muslim women had substantially higher postpartum ODS knowledge than any other religion. In conclusion, women's knowledge of ODS associated with labor and delivery and postpartum was low. Antenatal care must be encouraged and its content revised to ensure it covers potential late pregnancy complications.