Knowledge of danger signs during pregnancy and subsequent health seeking actions among women in Kinondoni municipality, Tanzania

Abstract

Background: Tanzania is among countries with a high maternal mortality rate. Every pregnant woman is at risk of developing pregnancy related complication. It is not understood if and how the information and education on danger signs of pregnancy; translate into appropriate actions when a woman experiences a danger sign. Knowledge and recognition of danger signs during pregnancy would result in timely emergency obstetric care. Objectives: This study aimed at determining knowledge on danger signs during pregnancy and subsequent health seeking actions among women who experienced danger signs. Methodology: This was a cross sectional study that enrolled 384 eligible postpartum women that delivered within the past six weeks from Magomeni and Sinza health centers, in Kinondoni Municipality, Dar-es-salaam, Tanzania. The women were interviewed using a semi structured Swahili questionnaire with closed and open ended questions. Systematic random sampling method was used to select the women to be interviewed. Descriptive and inferential analysis was done and associations between independent and dependent variables were computed. Results: Of the 384 women were interviewed, 95 percent had attended ANC at least once and 59 percent made four or more visits. Mean age was 26.8 and majority had two or more children. Knowledge of danger signs was low (31%); commonly mentioned danger signs were vaginal bleeding (81.2%), swelling of fingers, face and legs (46.3%) and severe headache with blurred vision (43.6%). In bivariate analysis age, education and occupation were associated with knowledge on danger signs during pregnancy (P≤0.05). In multivariate logistic regression, age and occupation were statistically significant associated with knowledge on danger signs. Having older age was eight times more likely (OR 8.1; CI 1.6-42) to have knowledge on danger signs compared to young ones (≤20 years); self-employed women were two times more likely (OR=1.9; CI; 1.1-3.3) to have knowledge on danger signs compared to being employed. Of the 69 women who reported a danger sign in the last pregnancy, 75 percent took appropriate health seeking action. However, attendance of health facility for care was significantly related to knowledge only for difficulty in breathing (P=0.023) and swelling of fingers, face and legs (P= 0.035). It was established that knowledge on danger signs did not significantly relate to appropriate actions taken when the women experienced danger signs. ix Conclusion: Knowledge on danger signs during pregnancy is low. Appropriate health care seeking actions were observed among women who had fever and difficulty in breathing for those who had experienced danger signs. Knowledge of danger sign during pregnancy was not translated into appropriate actions. Recommendations: The quality of ANC care particularly health education should be evaluated. Further studies are recommended to address the knowledge gap and to understand why knowledge was not positively translated into actions regarding experiencing danger signs during pregnancy. Community based projects should be initiated to provide childbearing health education.