Factors influencing birth preparedness and complication readiness during pregnancy in Turkana County, Kenya

Abstract

Introduction: pregnancy, childbirth, and the postnatal period involve risks that can lead to serious complications, but these can be reduced when mothers and families are aware of key obstetric danger signs and follow a birth preparedness plan. Methods: a convergent mixedmethods community-based cross-sectional study was conducted among 331 pregnant women in August 2024. Additionally, six key informant interviews and six focus group discussions were held with health workers, pregnant women, and their partners. Quantitative data were analyzed using SPSS v27.0, while qualitative data underwent content analysis. Bivariate and multivariate logistic regressions were employed to identify factors influencing birth preparedness. Results: only 17.2% of pregnant women were prepared for birth and complications. Awareness of key danger signs was low: 13.5% during pregnancy, 8.9% during labor and childbirth, and 21.9% in the postpartum period. Factors significantly associated with higher odds of birth preparedness included: being a housewife (AOR= 5.6), receiving health education on danger signs (AOR= 4.68), having good knowledge of danger signs during pregnancy (AOR= 3.39), and receiving any form of community support (AOR= 2.74). Conclusion: birth preparedness and awareness of obstetric danger signs are low among pregnant women in Turkana County. Influencing factors include socio-demographic, cultural, economic, and infrastructural challenges. Qualitative research identified cultural beliefs, the utilization of conventional remedies, and inadequate infrastructure and distance as significant roadblocks to health services. To enhance birth preparedness and complication readiness (BPCR) initiatives in Turkana County, it is recommended that targeted, context-specific health education be implemented during antenatal care clinics. This should involve delivering accurate and relevant health education on obstetric danger signs and the importance of birth preparedness through these clinics. Addressing knowledge gaps among pregnant women and their partners is essential to reduce delays in seeking emergency obstetric care. The Ministry of Health and county governments should expand health facility capacity and provide regular training on focused antenatal care and communication. Community health workers should be recruited and supported to promote antenatal care (ANC) attendance and institutional deliveries through local outreach. To improve access to health centres, county governments and international non-governmental organizations (INGOs) should tackle physical, financial, and social barriers by improving transportation and reaching remote areas