Birth preparedness and complications readiness among pregnant women living with HIV attending antenatal care at Kawempe national referral hospital

Abstract

Background: Pregnancy in women living with HIV poses unique challenges that necessitate specialized care to ensure favourable maternal and neonatal outcomes. Birth preparedness and complications readiness (BP/CR) is a critical component in optimizing maternal health services utilization. This aims at encouraging all pregnant women and the communities in which they live to effectively plan for births and deal with emergencies that may occur because of the natural progress of pregnancy and birth. This study aimed to assess the levels of BP/CR among pregnant women living with HIV, identify associated factors, and contribute valuable insights to inform targeted interventions. Methods: A cross-sectional design was employed to collect data from 350 pregnant women living with HIV attending antenatal care clinics in Kawempe National Referral Hospital (KNRH). A structured questionnaire was used to collect the data which was analysed using Stata 13 software. A participant was considered prepared if she had fulfilled 5 out of 7 BPCR parameters at the time of data collection. Logistic regression analysis including bivariate and multivariate analysis was used to assess the factors associated with BPCR. A P-Value <0.05 was considered statistically significant. Results: More than half (63.4%) of the mothers were prepared for birth of which 100% had identified a place of delivery, 96.3% had identified means of transport, 93.4% had identified an attendant and 71.1% had identified a skilled health care provider. Only 4% had however identified a blood donor. Majority of the participants (96.0%) were aware of danger signs of pregnancy with vaginal bleeding (95.8%) as the most known danger sign of pregnancy. On multivariate analysis, participants who were married were 2 times more likely to be prepared as compared to those who were not married (aOR=1.90 (1.032 - 3.498], P=0.039). Participants who were in their 1st trimester (aOR=0.11 [95% CI 0.034 - 0.375], P=0.0001) or second (aOR=0.30 [95% CI 0.184 - 0.5], p=0.0001) were significantly less likely to be prepared as compared to those in their third trimester. Conclusion: Practice of BPCR among HIV positive pregnant women was moderate as 6 in 10 mothers were found prepared, practices which were significantly associated with marital status and gestation age of the pregnancy. There is need for community-based support services, counseling, and practical assistance to support HIV positive unmarried women and those without strong social support networks to effectively prepare for birth.