Comparative Study of Knowledge, Attitude and Practice of Birth Preparedness and Emergency Readiness among Pregnant Women Attending Antenatal Clinic in Secondary and Tertiary Hospitals in Port Harcourt Metropolis

Abstract

Birth Preparedness and Emergency Readiness (BPER) are vital aspects of antenatal care aimed at reducing maternal and neonatal morbidity and mortality by ensuring women are well-prepared for childbirth and emergencies. This study assessed BPER plans among pregnant women attending antenatal clinics in selected public secondary and tertiary hospitals in Port Harcourt metropolis, Rivers State, Nigeria. A comparative cross-sectional design was used, involving 1,084 participants selected through multi-staged clustered sampling. Data were collected using structured questionnaires and analyzed to explore associations between socio-demographic factors and BPER knowledge, attitude, and practice. Findings showed that the majority of secondary facility respondents were aged 25–29 years (54.45%) compared to 45.2% in tertiary facilities (p = 0.0001). Most had secondary education—63.3% in secondary and 69.0% in tertiary facilities (p = 0.0001). Unemployment was higher in tertiary facilities (42.4%) than secondary (35.6%) (p = 0.0001). Christianity was the predominant religion in both groups, with no significant difference (p = 0.509). Regarding BPER knowledge, 83.4% of secondary and 86.7% of tertiary respondents had good knowledge (p = 0.125). Attitudes were more positive in tertiary facilities (96.9%) than secondary (89.7%) (p = 0.0001). However, BPER practice was poorer in secondary facilities (84.9%) compared to tertiary (77.1%) (p = 0.001). Factors such as miscarriage history, pregnancy complications, and multiple pregnancies were significantly associated with BPER practice (p = 0.0001). Despite high knowledge and attitude levels, BPER practice remained suboptimal, especially in secondary facilities. The study recommends enhanced education for healthcare providers on key BPER components, skilled birth attendants, emergency transport, financial planning, and blood donation, particularly in secondary healthcare settings.