Strategies for helping families prepare for birth: experiences from eastern central Uganda

Figures & data

Table 1 Demographic and healthcare characteristics for the three study districts

Characteristics	Buyende	Luuka	Iganga
Residence	Rural, remote	Rural	Mostly rural
Population	248,000^a	243,200^a	466,200^a
Health facilities (HF)	21	31	52
HF level III with MNC	4	6	6
HF level IV with MNC	1	1	1
Interventions	Voucher scheme	none	UNEST

MNC=maternal and newborn care. ^aFrom health system assessment 2011 (16).

Fig. 1 Sampling procedure in three study districts in eastern central Uganda.

Table 2 Socio-demographic characteristics of the sample

Characteristic	Frequency n (%)
District (n=2,010)
Buyende	819 (40.7)
Luuka	797 (39.7)
Iganga	394 (19.6)
Marital status (n=2,007)
Not married	179 (8.9)
Married	1,828 (91.1)
Respondent's age (n=2,006)
≤ 19 years	326 (16.3)
20–39 years	1,507 (75.1)
≥ 40 years	69 (3.4)
Do not know	104 (5.2)
Religion (n=2,009)
Christian	1,379 (68.6)
Muslim	612 (30.4)
Other	18 (0.9)
Respondent's education (n=2,008)
No school	256 (12.7)
Primary	1,347 (67.1)
≥ Secondary	405 (20.2)
Respondent's income (n=2,006)
Irregular	1,861 (92.8)
Regular	145 (7.2)
Husband's education (n=1,753)
No school	108 (6.2)
Primary	959 (54.7)
≥ Secondary	686 (39.1)
Husband's income (n=1,753)
Irregular	1,334 (76.1)
Regular	419 (23.9)

Table 3 Reproductive health and socio-economic patterns of the sample

Characteristics	Frequency n (%)
Number of children (n=2,009)
1	329 (16.4)
2–3	597 (29.7)
4–5	434 (21.6)
≥6	649 (32.3)
ANC attendance (n=1,990)
0–3 times	1,057 (53.1)
≥4 times	933 (46.9)
When was first ANC visit – trimester (n=1,967)
1st	668 (34.0)
2nd	1,131 (57.5)
3rd	168 (8.5)
Told about pregnancy DS and where to seek help if they occur (n=2,005)
None	1,595 (79.6)
Yes – DS	43 (2.1)
Yes – both	367 (18.3)
Visited by healthcare provider during pregnancy (n=2,010)
No visits	1,935 (96.3)
Health professional	38 (1.9)
CHW/VHT	32 (1.6)
Other	5 (0.2)
Delivered at health facility (n=2,009)
No	586 (29.2)
Yes	1,418 (70.8)
Decision making regarding mother's and newborn's health (n=2,008)
Herself	157 (7.8)
Husband	1,674 (83.4)
Together	29 (1.4)
Other	148 (7.4)
Escorted by husband to place of delivery (n=1,887)
No	739 (39.2)
Yes	1,148 (60.8)

CHW/VHT=community health worker/village health team.

Fig. 2 ANC practices among respondents (%) of three study districts.

DSP=danger signs during pregnancy; *statistically significant differences (p<0.05).

Fig. 3 Respondents (%) taking individual and all three birth preparedness actions in the study districts.

*Statistically significant differences (p<0.05).

Table 4 Birth preparedness^a characteristics

Characteristics	Frequency n (%)
Birth prepared^b (n=2,010)
Yes	497 (24.7)
No	1,513 (75.3)
Steps taken (n=2,010)
None	148 (7.4)
1 out of 3 steps	465 (23.1)
2 out of 3 steps	900 (44.8)
All 3 steps	497 (24.7)

^aBirth preparedness steps: Identification of location for the delivery, saving for transport and other expenses, and procurement of four essential birth materials (razor, thread, sheet, and gloves).

^b‘Birth prepared’ was deemed a woman who had performed all three steps of birth preparedness by not later than 1 week before delivery.

Table 5 Multivariable logistic regression analysis for associations with birth preparedness

	Pooled sample			Buyende			Luuka			Iganga
	ORA	95% CI	p	ORA	95% CI	p	ORA	95% CI	p	ORA	95% CI	p
District
Buyende	0.37	0.27–0.51	0.0001
Luuka	0.72	0.54–0.98	0.035
Iganga	Ref
ANC attendance
0–3 times	Ref			Ref			^a			Ref
≥ 4 times	1.42	1.10–1.83	0.007	2.20	1.38–3.51	0.001				1.66	1.05–2.61	0.030
When was 1st ANC visit – trimester
1st	1.94	1.09–3.44	0.024	^a			3.23	1.22–8.60	0.019	^a
2nd	1.87	1.09–3.22	0.023				2.59	0.98–6.82	0.054
3rd	Ref						Ref
Told about pregnancy DS and where to seek help if they occur
None	Ref			Ref			Ref			^a
Yes – DS	0.49	0.20–1.20	0.119	0.00	0.00	0.999	0.41	0.12–1.42	0.158
Yes – both	2.07	1.57–2.74	0.0001	2.04	1.21–3.44	0.007	2.15	1.41–3.28	0.0001
Visited by healthcare provider during pregnancy
No visits	^a			Ref			^a			^a
Health professional				14.40	2.70–76.84	0.002
CHW/VHT				0.00	0.00	0.999
Other				0.00	0.00	1.000
Decision making regarding mother's and newborn's health
Herself	^a			Ref			^b			^a
Husband				0.29	0.14–0.61	0.001
Partners together				0.24	0.04–1.38	0.109
Others				0.40	0.13–1.18	0.097
Escorted by husband to the place of delivery
No	Ref			^a			Ref			^a
Yes	1.47	1.15–1.89	0.003				1.70	1.16–2.50	0.007
Quintiles of asset ownership index
1 (poorest)	Ref			Ref			^a			^a
2	1.04	0.69–1.57	0.859	1.91	0.95–3.83	0.070
3	1.12	0.74–1.69	0.589	1.43	0.67–3.06	0.361
4	1.26	0.84–1.89	0.265	1.94	0.95–3.96	0.07
5	2.04	1.38–3.01	0.0001	3.69	1.80–7.60	0.0001
Respondent's income
Irregular	Ref			Ref			^a			^a
Regular	1.83	1.20–2.79	0.005	2.25	1.09–4.64	0.029
Husband's income
Irregular	^a			^a			^a			Ref
Regular										2.04	1.25–3.31	0.004

^aNot significantly associated with the outcome, ^bOR and 95% CI with p value<0.05 are highlighted in bold.

MoH-Uganda, (Ministry of Health Uganda), Health Systems 20/20, Makarere University School of Public Health. Uganda health system assessment 2011. 2012. Available from: http://health.go.ug/docs/hsa.pdf [cited 20 April 2013].

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