Counseling and Knowledge of Danger Signs of Pregnancy Complications in Haiti, Malawi, and Senegal

Objectives Providing counseling on danger signs of pregnancy complications as part of visits for antenatal care (ANC) can raise expecting women's awareness so that if danger signs occur they can seek assistance in time. The study examines the level of agreement in counseling on danger signs between observation of the provider during the ANC visit and the client's report in the exit interview, and the association of this agreement with the client's level of knowledge on danger signs. Methods The analysis used data from service provision and assessment (SPA) surveys in Haiti, Malawi, and Senegal. Agreement between the observation and client's report was measured by Cohen's kappa and percent agreement. Regressions were performed on the number of danger signs the client knew, with the level of agreement on the counseling on danger signs as the main independent variable. Results The study found little agreement between the observation of counseling and the client's report that the counseling occurred, despite the fact that the exit interview with the client was performed immediately following the ANC visit with the provider. The level of positive agreement between observation and client's report was 17% in Haiti, 33% in Malawi, and 23% in Senegal. Clients' overall knowledge of danger signs was low; in all three countries the mean number of danger signs known was 1.5 or less. The regression analysis found that, in order to show a significant increase in knowledge of danger signs, it was important for the client to report that it took place. Conclusions Ideally, there should be 100% positive agreement that counseling occurred. To achieve this level requires raising both the level of counseling on danger signs of pregnancy complications and its quality. While challenges exist, providing counseling that is more client-centered and focuses on the client's needs could improve quality and thus could increase the client's knowledge of danger signs

Family medicine · Medical emergency · Pregnancy · Public health · Signs and symptoms · Vital signs · Warning signs · Food Security and Health in Diverse Populations · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Nursing · Pediatrics · Surgery

• Comparing the use of direct observation, standardized patients and exit interviews in low- and middle-income countries

  Open Access•Navneet Aujla, Yen-Fu Chen et al.•Health Policy and Planning•2021

  Incluir item

• World Trade Report 2006

  World Trade Organization•World Trade Report 2006•2006

  Incluir item

• The Quality of Care

  Avedis Donabedian•JAMA•1988

  Incluir item

• WHO analysis of causes of maternal death

  Open Access•Khalid S Khan, Daniel Wojdyla et al.•The Lancet•2006

  Incluir item

• Maternal mortality

  Open Access•Carine Ronsmans, Warren Graham et al.•The Lancet•2006

  Incluir item

• The enduring and evolving nature of the patient–physician relationship

  Open Access•Debra Roter•Patient Education and Counseling•2000

  Incluir item

• Interrater reliability

  Open Access•Marry L McHugh•Biochemia Medica•2012

  Incluir item

• Increasing Awareness of Danger Signs in Pregnancy Through Community- and Clinic-Based Education in Guatemala

  Open Access•Krista M Perreira, Patricia Bailey et al.•Maternal and Child Health Journal•2002

  Incluir item

• Capacity constraints to the adoption of new interventions

  Open Access•Thomas Adam, Taghreed Adam et al.•Health Policy and Planning•2005

  Incluir item

• Providing information on pregnancy complications during antenatal visits

  Open Access•Béatrice Nikièma, Gervais Beninguisse et al.•Health Policy and Planning•2009

  Incluir item

• Fundamental Elements of the Quality of Care

  Judith Bruce•Studies in Family Planning•1990

  Incluir item

• Accuracy of Standard Measures of Family Planning Service Quality

  Open Access•Katherine Tumlinson, Ilene S Speizer et al.•Studies in Family Planning•2014

  Incluir item

• Medication decision-making and management

  Open Access•Betty Chewning, Betsy Sleath•Social Science & Medicine•1996

  Incluir item