Spatial Differences in Knowledge and Perception of Key Danger Signs of Pregnancy among Mothers in Ebonyi State, Nigeria

Background: To determine knowledge and perception of key danger signs of pregnancy among mothers in urban and rural communities of Ebonyi State, Nigeria.

Methodology: A comparative cross-sectional study design was used. The two-stage sampling technique was used to select 660 women in four of thirteen local government areas in the state. The women have delivered in the last one year irrespective of place of delivery. Outcome measure included good knowledge of danger signs and was assessed by the proportion of respondents who recalled four of eight danger signs. Positive perception was assessed by the proportion who were aware that danger signs of pregnancy were capable of causing the death of women if unattended to immediately.

Results: The mean age of respondents was urban, 29.6±6.2 and rural, 28.6±5.1 years. The most recalled danger sign was bleeding before labour; urban, 280 (84.8%); rural,267 (80.9%). Comparable proportions - urban, 272 (82.4%); rural, 287 (87.0%) had good knowledge of danger signs. (p=0.105). Predictors of good knowledge of danger signs included residing in urban, (AOR=0.4; 95%C1:0.2-0.9), being <30 years, (AOR=0.6; 95%C1:0.3-0.9), having 2-4 children, (AOR=2.4; 95%C1:1.2-4.7) and not receiving antenatal care from a skilled provider. (AOR=0.2; 95%C1:0.08-0.4). There was an association between good knowledge and a positive perception of danger signs. (p<0.001).

Conclusions: The majority of respondents in the study area had good knowledge and a positive perception of danger signs of pregnancy. Consolidating the understanding of danger signs will enhance maternal health outcomes thus improving the maternal death burden in Nigeria. There is a need to ensure that all women receive antenatal care from a skilled provider.