Affiliations: Department of International Health, Johns Hopkins
Bloomberg School of Public Health, Baltimore, MD 21205, USA | Department of Population, Family and Reproductive
Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205,
USA | Urban Health Resource Centre, New Delhi, India | King George Medical University, Lucknow, India
Note: [] Corresponding author: Abdullah H. Baqui, Johns Hopkins Bloomberg
School of Public Health, 615 N. Wolfe St., Ste. E-8138, Baltimore, MD 21205,
USA. Tel.: +1 410 955 3850; Fax: +1 410 614 1419; E-mail: abaqui@jhsph.edu
Abstract: Background: Emergency birth preparedness has been promoted to
address delays in seeking skilled care at birth. However, little evidence is
available for the effectiveness of birth preparedness in the context of large
scale programs. This analysis uses data from the evaluation of a
community-based maternal and newborn care program in rural India to examine the
association between birth preparedness and use of a skilled birth
attendant. Methods: Community-based workers counseled pregnant women on
maternal and newborn care, including four emergency birth preparedness steps:
1) identifying a health facility, 2) identifying a person to accompany the
mother, 3) arranging for transport, and 4) saving money. Logistic regression
was used to assess the association between taking any emergency birth
preparedness step and using a skilled birth attendant. Results: Of the 8,069 women who gave birth during 2004–2005,
51.8% (n = 4,183) took at least one emergency birth preparedness step. In the
adjusted analysis, women who took at least one birth preparedness step were 45%
more likely to have skilled care at birth [OR: 1.45; 95% CI:
1.30–1.63]. Conclusions: Promoting emergency birth preparedness in
community-based maternal and newborn care programs may increase the utilization
of skilled birth attendants.
Keywords: Birth preparedness, skilled birth attendance, maternal health, newborn health, community health workers
