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Knowledge and Attitude of Pregnant Women Towards Preeclampsia and Its Associated Factors in South Gondar Zone, Northwest Ethiopi

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Knowledge and Attitude of Pregnant Women Towards Preeclampsia and Its Associated Factors in South Gondar Zone, Northwest Ethiopi Mekie et al. BMC Pregnancy and Childbirth (2021) 21:160 https://doi.org/10.1186/s12884-021-03647-2 RESEARCH ARTICLE Open Access Knowledge and attitude of pregnant women towards preeclampsia and its associated factors in South Gondar Zone, Northwest Ethiopia: a multi‐center facility‐ based cross‐sectional study Maru Mekie1*, Dagne Addisu1, Minale Bezie1, Abenezer Melkie1, Dejen Getaneh2, Wubet Alebachew Bayih2 and Wubet Taklual3 Abstract Background: Preeclampsia has the greatest impact on maternal mortality which complicates nearly a tenth of pregnancies worldwide. It is one of the top five maternal mortality causes and responsible for 16 % of direct maternal death in Ethiopia. Little is known about the level of knowledge and attitude towards preeclampsia in Ethiopia. This study was designed to assess the knowledge and attitude towards preeclampsia and its associated factors in South Gondar, Northwest Ethiopia. Methods: A multicenter facility-based cross-sectional study was implemented in four selected hospitals of South Gondar Zone among 423 pregnant women. Multistage random sampling and systematic random sampling techniques were used to select the study sites and the study participants respectively. Data were entered in EpiData version 3.1 while cleaned and analyzed by Statistical Package for Social Sciences (SPSS) version 23. Descriptive and inferential statistics were performed. Adjusted odds ratio with 95 % confidence interval were used to identify the significance of the association between the level of knowledge on preeclampsia and its predictors. Results: In this study, 118 (28.8 %), 120 (29.3 %) of the study participants had good knowledge and a positive attitude towards preeclampsia respectively. The likelihood of having good knowledge on preeclampsia was found to be low among women with no education (AOR = 0.22, 95 % CI (0.06, 0.85)), one antenatal care visit (ANC) (AOR = 0.13, 95 % CI (0.03, 0.59)). Whereas, those who booked for ANC in the first trimester (AOR = 6.59, 95 % CI (1.43, 30.33)), gave the last birth at a health facility (AOR = 2.61, 955 CI (1.03, 6.61)), and experienced a complication during previous births (AOR = 3.67, 95 % CI (1.78, 7.57)) were more likely to be knowledgeable on preeclampsia. (Continued on next page) * Correspondence: [email protected] 1Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia Full list of author information is available at the end of the article © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Mekie et al. BMC Pregnancy and Childbirth (2021) 21:160 Page 2 of 9 (Continued from previous page) Conclusions: No formal education and not attending four ANC visits were associated with poor knowledge of preeclampsia. While participants who visited health facilities during the first trimester, who gave birth at health facilities, and those who experienced a complication in previous births were more likely to be knowledgeable on preeclampsia. Improving the numbers of ANC visits and encouraging facility delivery are important measures to improve women’s knowledge on preeclampsia. Health education regarding preeclampsia risk factors, symptoms, and complications shall be emphasized. Keywords: Preeclampsia, Knowledge, Attitude, Maternal mortality, Ethiopia Background ascertainment and treatment are key intervention strat- Preeclampsia has the greatest impact on maternal mor- egies especially in resource-limited areas [5]. Studies tality which complicates nearly a tenth of pregnancies conducted in different parts of the world indicated that worldwide [1–4]. It is the second leading cause of direct there is a significant gap among pregnant women related maternal death and directly responsible for 70,000 ma- to knowledge, attitude, and perception towards pre- ternal deaths annually at the global level [4, 5]although eclampsia [16–18] which directly or indirectly influence the exact prevalence of morbidity and mortality related health seeking-behavior leading to increased maternal to preeclampsia is not reported in the developing coun- mortality and morbidity [12, 13]. tries. Preeclampsia is one of the top five maternal mor- A study in Australia revealed that 77 % of women did tality causes and responsible for 16 % of direct maternal not know about preeclampsia before diagnosis. Even death in Ethiopia [6–8]. The majority of deaths related among women who were diagnosed with preeclampsia, to preeclampsia could be averted by evidence-based, ef- half of them did not understand the seriousness of pre- fective, and timely interventions by increasing women’s eclampsia [16]. Understanding the level of knowledge knowledge and changing attitudes towards preeclamp- and attitude of women about preeclampsia is essential to sia [9, 10]. undertake appropriate measures [16, 19]. To the best of Studies indicated that pregnant women have poor the authors’ knowledge, studies are limited in Ethiopia knowledge and wrong perception about preeclampsia regarding the knowledgeand attitude of pregnant women despite its relevance for early identification and manage- towards preeclampsia. ment of the problem [8, 11]. A study conducted in a District Hospital in Tanzania indicated that 60 % of the Methods study participants did not know the consequences of Study Design and Period preeclampsia. Lack of knowledge is found to be the A multicenter facility-based cross-sectional study de- predisposing factor to practice risky behaviors for sign was implemented in four selected hospitals (Debre preeclampsia. In the same way, poor understanding of Tabor General Hospital, Addis Zemen Primary Hospital, the disease leads to anxiety and becomes a source of Mekane Eyesus Primary Hospital, and Nefas Mewucha stress to the family as well [12, 13]. Primary Hospital found in South Gondar Zone of North- Globally, the maternal mortality ratio declined to 216 west Ethiopia from January 5 to February 5/2020. The per 100, 000 live births from 385 to 100,000 live births four hospitals were selected for the study purpose out of in 2015 [14] despite the reduction was not consistent eight hospitals in the Administrative Zone. across countries. Countries have to strive hard to ac- complish the Sustainable Development Goals (SDGs) Study Population which demands more commitment than Millennium De- All pregnant women who came to receive antenatal care velopment Goals (MDGs) [15]. Morbidity and mortality (ANC) services in the selected Hospitals were the source related to preeclampsia might be attributed to poor population. While pregnant women who visit the ANC knowledge and negative attitude of pregnant women. clinics in the selected Hospitals during the study period There are several problems related to preeclampsia were the study population. On the other hand, those prevention and diagnosis such as challenges in the pre- who visited the ANC clinics for the diagnosis of preg- diction, prevention, delay in transport, and management nancy were excluded. of preeclampsia which are complemented by the short- age of trained health personnel and poor health infra- Sample size determination and Sampling procedures structures in developing countries [11]. To address the A single population proportion formula was used to burden of preeclampsia-related consequences, shifting calculate sample size at 95 % confidence interval, 5 % from clinic-based care to community-based case- margin of error, and taking proportion (p) of 0.5 (since Mekie et al. BMC Pregnancy and Childbirth (2021) 21:160 Page 3 of 9 therewas no similar previous study). Thus, a prevalence included in the pretest was 5 % of the number of preg- of 50 % was taken to obtain the maximum possible sam- nant women calculated as the sample size. The data col- ple size. After adding a 10 % non-response rate, the final lection tool has four sections. These are socio- sample was 423. A multistage random sampling tech- demographic parts, obstetric characteristics, knowledge, nique was used to select study participants by stratifying and attitude measurement questions related to pre- hospitals as primary and general hospitals. As of 2020, eclampsia. The questionnaire was prepared in English, there are 8 hospitals in South Gondar Zone Administra- translated to Amharic, and then back to English to en- tion (1 general and 7 primary hospitals). Debre Tabor sure consistency. To ascertain data quality, data collec- General Hospital (DTGH) was taken for the general tion and supervision were facilitated by trained health hospital. While, three
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