Postpartum Women’s Knowledge of Obstetric Danger Signs: A cross-sectional Survey at Harare Hospital, Zimbabwe

Abstract

Background Knowledge of obstetric danger signs empowers women enabling them to recognise obstetric danger signs early so they may seek timely medical help. Maternal mortality remains high in Zimbabwe with some women succumbing to preventable complications of obstetric conditions due to late recognition of danger signs. Yet little is known about current levels of knowledge of obstetric danger signs, the information sources among Zimbabwean women. Thus the aim of the study was to assess knowledge of obstetric danger signs and information sources among postpartum women at Harare Hospital, Zimbabwe. Methods An institutionally based cross-sectional survey was conducted at Harare Hospital, Zimbabwe. This study included 401 postpartum women seeking services at postnatal clinic, neonatal unit, and in postnatal ward. An interviewer-administered structured questionnaire was used to collect data. Univariate, bivariate analyses and regression statistics were used to estimate prevalence, describe characteristics and explore factors determining knowledge of obstetric danger signs. Statistical significance was set at p<0.05. Results Educational level, and exposure to relatives, radio/TV and community-based sources of information were significantly associated with knowledge of danger signs. Two hundred and seventy-one (70%) of the respondents had good knowledge of obstetric danger signs. Health care workers were the commonest source (70.5%) of information on obstetric danger signs. Women who had more than secondary level education had threefold likelihood of being knowledgeable [AOR = 3.520; 95% CI (1.245, 9.949)]. Participants who did not obtain information through relatives [AOR = 0.431; 95% CI (0.217, 0.855)], radio/TV [AOR = 0.290; 95% CI (0.104, 0.810)] and community-based sources of information [AOR = 0.488; 95% CI (0.257, 0.927)] were significantly less likely to have knowledge of danger signs. Health care workers were not a significant source of information [AOR = 1.044; 95% CI (0.350, 3.120)]. Virtually all women agreed that their knowledge could be improved if more time was spent in counselling, the client-provider relationship was more bidirectional, and if they had resources providing more information outside of the health care setting. Conclusion While prevalence of knowledge is high among women, actual range of signs known is low. Educational level, and exposure to relatives, radio/TV and community-based sources of information were significantly associated with knowledge of danger signs. Limited counselling time, unidirectional patient-client interactions, and lack of information resources outside of the health care setting remain major reasons that may be accounting for the low knowledge. Notwithstanding that research is needed to fully establish the true prevalence of obstetric danger signs knowledge and associated factors on a national level, the Government of Zimbabwe needs to strengthen its IEC strategy by harnessing community-based and mass media approaches.