Birth Day - International Childbirth Education Association

Poor Knowledge of Causes and Prevention of Stillbirths Among Health Care Providers
continued from previous page
et al 2003; Njokanma et al 1994; Orji et al 2006]. In fact,
stillbirths contribute significantly to perinatal mortality in
developing countries where infection, malnutrition and
poor obstetric care are still perennial problems [Kuti et al
2003; Njokanma et al 1994]. The perinatal mortality rate
(PMR) in advanced countries where adequate nutrition
health and obstetric care exist, is put at 10 to 20 per 1000
births as compared to 60 to 120 per 1000 births in developing
countries [Kuti et al 2003; Njokanma et al 1994; Orji
et al 2006; Orji 2002; Fasubaa et al 2003; Kuti et al 2003;
Ojofeitimi et al 2008]. The PMR in Nigeria, for example, has
been reported to be very high and it ranges from 30 to 120
[Onadeko and Lawoyin 2003; Olusanya et al 2006; Kuti et al
2003; Njokanma et al 1994].
While several studies have substantiated the common
causes of stillbirths in developing countries to include
teenage and advanced maternal age pregnancy, high parity,
prolonged obstructed labour, high level of caesarean section
refusal, type 2 diabetes, malnutrition, infection, inadequate
prenatal care and lack of emergency obstetric care [Onadeko
and Lawoyin 2003; Olusanya et al 2006; Kuti et al 2003;
Njokanma et al 1994; Orji et al 2006; Orji 2002; Fasubaa et
al 2003; Kuti et al 2003; Ojofeitimi et al 2008; Fretts 2005;
Lawoyin 2007; Adimora and Odetunde 2007; Onwuhafua
and Oguntayo 2006; Sule and Onayade 2006], none of the
studies cited in the literature has ever assessed the level of
knowledge of causes and prevention of stillbirths among the
health care providers let alone among the nursing mothers
and pregnant women. It is therefore pertinent to periodically
assess the level of knowledge of health care providers on the
causes and prevention of stillbirths, especially, in developing
countries such as Nigeria where the PMR, under age
five and infant mortality rates are still very high [Onadeko
and Lawoyin 2003; Olusanya et al 2006; Kuti et al 2003;
Njokanma et al 1994; Orji et al 2006; Orji 2002; Fasubaa et
al 2003; Kuti et al 2003]. After all, stillbirths are preventable
and the health care providers are the custodians of health
information that is required to reduce PMR.
Materials and Methods
Subjects: A total of 201 workers including medical
students, nursing officers and Community Health Officers
were interviewed. The respondents comprised of 134 medical
students, 35 Community Health Officers and 32 practicing
nursing officers. The subjects were purposefully selected from
two health institutions in Osun state, Nigeria. The medical
students have had full posting in obstetrics and pediatrics,
while the Community Health Officers in training and nursing
officers have had more than eight years in health care
delivery at antenatal clinics.
Data collection on assessment of knowledge of
causes and prevention of stillbirths: A semi-structured
questionnaire containing open and close ended questions
was employed to solicit the respondent’s knowledge on
the most common known causes of stillbirths; difference
between miscarriage and stillbirth; some factors that can
increase a mother’s risk of having stillbirth; and steps to be
taken to prevent stillbirth.
Scoring Technique: This was based on the review of
literature as to the commonly known causes of stillbirths,
definition of stillbirth and miscarriage, factors that increase
a mother’s risk of stillbirth and steps to be taken on prevention
of stillbirth. The correct responses were scored a point
each. The total maximum possible score was 21. A total score
less than 5 was interpreted as very poor. A total score from
5-8 was graded as poor. A total score from 9-12 was rated
as fair and a total score of above 13 was interpreted as good
knowledge of the subject matter.
Statistical Analysis: After the levels of knowledge
among the health care providers were scored, coded and
grouped, the following null hypothesis was used: that there
was no statistical difference between educational status,
cadre, marital status, age and level of knowledge on cause
and prevention of stillbirth. The null hypothesis was tested
using Fisher’s Chi-square table. A probability, P