CHAPTER 4

ANALYSIS AND INTERPRETATION

This chapter deals with the analysis and interpretation of data collected from 200 study
participants ( antenatal mothers ) for quantitative data analysis in selected Primary
Health Centers of New Delhi. The present study was to assess Birth Preparedness and
Complication Readiness (BPACR) status in antenatal mothers of Selected Primary
Health Centre of New Delhi.

According to Polit and Beck, “Analysis is a process of organizing and synthesizing data
so as to answer research question and test hypothesis.”Analysis refers to the method of
organizing data in such a way that research questions can be answered. The analysis of
quantitative data deals with information collected during research study, which can be
quantified and statistical calculations, can be computed.

According to Sharma interpretation means, “ The result of the data analysis are studied
and then making inferences about the relations and drwaing conclusions about these
relations.” Interpretation involves making sense of study results and examining their
implications. It also involves envisioning how the new evidence can be used in clinical
practice, and what further research is needed.

Data was entered and analyzed by using SPSS windows version 16. Simple frequency
distribution tables were created. Comparison of the proportion of women who had
knowledge on BPCR and plan for birth by each category of the independent variables
were done, and statistical correlation was assessed using parametric test.

In the present study analysis and interpretation were done using descriptive statistics
based on following objectives:-

 To assess the status of Birth preparedness and Complication Readiness (BPACR)

in antenatal mothers.

 To assess relationship of Birth preparedness and Complication Readiness

(BPACR) in antenatal mothers with selected demographic variables.
The data was tabulated in Microsoft excel spreadsheet and analysis was doing using
descriptive statistics using SPSS version 16.

Hypothesis:-

H0 = There will be significant relationship between Birth preparedness and

Complication Readiness (BPACR) in antenatal mothers and various demographic
variables at 0.05 level of significance.

Part A:- Description of demographic characteristics of 200 antenatal mothers

This part describes the frequency and percentage distribution of demographic

characteristics of 200 antenatal mothers in terms of demographic data of study subjects,
that is age of the mother (in years), marital status of the mother, education of the
mother, parity, type of family, residential area, occupation of the husband, occupation
of the mother and religion.

Part B:- Consist of 3 sections related to findings related to BPACR score and its
relationships with various demographic variables.

Section I:- Birth Preparedness and Complication Readiness (BPACR ) score of 200
antenatal mothers obtained.

Section II:- Birth Preparedness and Complication Readiness (BPACR ) status of 200
antenatal mothers.

Section III:- Relationship of Birth preparedness and Complication Readiness

(BPACR) in antenatal mothers with selected demographic variables
 PART - A
Description of demographic characteristics of 200 antenatal
mothers
This part describes the demographic characteristics of 200 antenatal mothers in terms
of demographic data of study subjects, that is age of the mother (in years), marital status
of the mother, education of the mother, parity, type of family, residential area,
occupation of the husband, occupation of the mother and religion.

The data were compiled and presented in form of table and graphs.

Table 1: Frequency percentage distribution of antenatal mothers by their socio-

demographic profile (age of the mother, marital status of the mother,
education of the mother, parity, type of family, residential area, occupation
of the husband, occupation of the mother and religion)

(n=200)

Demographic Variables Frequency Percentage Cummula

tive
( n = 200 ) ( in％) percentag
e ( in％)

1. Age of the mother

a) <20 34 17.0 17.0

b) 20-24 24 12.0 29.0

c) 25-29 63 31.5 60.5

d) 30-34 64 32.0 92.5

e) ≥35 15 7.5 100.0

2.Marital status of the mother

a) Married 196 98.0 98.0

b) Unmarried 1 0.5 98.5

c) Widowed 1 0.5 99.0

d) Separated 0 0 99.0

e) Divorcee 2 1.0 100.0

Education of the mother

a) Illiterate 23 11.5 11.5

b) Primary Education 18 9.0 20.5

c) Secondary Education 50 25.0 45.5

d) Senior Seconday 40 20.0 65.5

Education

e) Graduate 69 34.5 100.0

a) Post graduate 0 0 100.0

4.Parity

a) Nulliparous 20 10.0 10.0

b) Para 1 65 32.5 42.5

c) Para 2 99 49.5 92.0

d) Para <2 16 8.0 100.0

5. Type of family

a) Nuclear 94 47.0 47.0

b) Joint 94 47.0 94.0

c) Extended 12 6.0 100.0

6. Residential Area

a) Urban area 43 21.5 21.5

b) Rural area 28 14.0 35.5

c) Suburban area 126 63.0 100.0

Occupation of the Husband

a) Unemployed 1 0.5 .5

b) Self-employed 68 34.0 34.5

c) Government service 46 23.0 57.5

d) Private service 85 42.5 100.0

8 . Previous Still birth

a) Yes 5 2.5 2.5

b) No 195 97.5 100.0

9.Occupation of the mother

a) Housewife 147 73.5 73.5

b) Laborer 8 4.0 77.5

c) Self-employed 30 15.0 92.5

d) Government service 0 0.0 92.5

e) Private service 15 7.5 100.0

10.Religion

a) Hindu 190 95.0 95.0

a) Muslim 10 5.0 100.0

b) Christian 0 0.0 100.0

c) Sikhism 0 0.0 100.0

d) Budhism 0 0.0 100.0

e) Jainism 0 0.0 100.0

g) Other religion 0 0.0 100.0

Table 1 shows that most of the antenatal mother were in the age group of 30-34 i.e.
32%, followed by 31.5% of them were in the age group of 25-29, 17% were <20, 12%
were in the age group of 20-24 and only 7.5% were ≥35.

Majority of the antenatal mothers were married i.e. 98% (196) and only 0.5% were
unmarried and widowed and 1% were divorced.

Table shows that most of the antenatal mothers 34.5%(69) were graduate while
40(20%) subjects had completed senior secondary education. 50 (25.0%) had
completed secondary education. 23 antenatal mothers were found to be illiterate
(11.5%).
Majority of the antenatal mothers (49.5%) were para 2. 65 (32.5%) were para 1 and
only 20 were nulliparous i.e. 10%.

There were evident that antenatal mothers were equally distributed in terms of the
type of family they belong to i.e. 47% to nuclear and joint family, while only 6% were
in extended family.

Most of the antenatal mothers (63%) resides in suburban area and (21.5%) resides in
urban area while merely 14% resides in rural area.

Table also shows that most of the participant’s husband ( 42.5%) were in private
service. More than one-third were self-employed while 23% were in government
service and 0.5% were unemployed.

Majority of antenatal mothers did not experience still birth previously i.e. 97.5%
(195) while 2.5%(5) have had a still birth previously.

Most of the antenatal mothers 73.5% (147) were housewives, 15% were
self-employed , 7.5% were in private service and 4% were laborers.

Majority of antenatal mothers were hindu i.e 95%(195) and only 5% were muslims.
 PART - B

Section I:- Findings related to BPACR Score

This section displays the results related to Birth preparedness and Complication
Readiness status of antenatal mothers as calculate by various BPACR indicators
provide by JHPIEGO. Maternal and Neonatal health (MNH) Program, Birth
preparedness and complication readiness. A matrix of shared responsibilities.
Maternal and Neonatal Health. 2001

Table 2 : BPACR score of antenatal mothers

n =200

BPACR score Frequency Percent Cumulative Percent

0 18 9.0 9.0

1 11 5.5 14.5

2 14 7.0 21.5

3 37 18.5 40.0

4 42 21.0 61.0

5 28 14.0 75.0
6 27 13.5 88.5
7 23 11.5 100.0
Total 200 100.0

Table 2 depicts that most of the antenatal mothers out of 7 scored 4 i.e 21%(42),
18.5%(37) scored 3, 14%(28) scored 5, 13.5% scored 6/7, 11.5% (23) scored 7, 9%
scored 0, 7% scored 2 and 5.5% scored 1 out of 7.
Section II :- Findings related to BPACR status of antenatal
mothers

Table 3 : BPACR status of antenatal mothers

n = 200

BPACR Std
status Frequency Percent Mean Median Mode Deviation

Inadequate 44 22.0 3.91 4.00 4 2.031

Adequate 156 78.0

Total 200 100.0

Table 3 depicts that BPACR status of 156 antenatal mothers i.e. 78% was adequate and
22% (44) was found to be inadequate.
(JHPIEGO. Maternal and Neonatal health (MNH) Program, Birth preparedness and
complication readiness. A matrix of shared responsibilities. Maternal and Neonatal
Health. 2001)
Table 4 : Frequency percentage distribution of BPACR indicators of antenatal
mothers. N = 200

BPACR Indicators Frequency Percentage

Awareness about > 8 danger signs of pregnancy 52 26

Awareness about>3 essential ANC care 193 96.5

Identified skilled birth attendant for delivery 162 81

Identified mode of transportation 118 59

Awareness about transportation provided by government in Janani 55 27.5

Shishu Suraksh Karyakram (JSSK)

Awareness about financial assistance provided by government in 41 20.5

Janani Suraksh Yojana (JSY)

Saved money to pay for expenses during pregnancy. 85 42.5

BPACR index was calculated as Σ Indicator/7, which was 55.7%. Table 4 shows
BPACR indicators among study participants. After all the seven indicators calculated
with their respective percentages BPACR was 55.7%.

.
Section III:- Findings related to relationship of Birth
preparedness and Complication Readiness (BPACR) in
antenatal mothers with selected demographic variables

The chi-square test for independence, also called Pearson's chi-square test
or the chi-square test of association, is used to discover if there is a
relationship between two categorical variables.

Fisher's exact test is a statistical significance test used in the analysis

of contingency tables.

The test is useful for categorical data that result from classifying objects
in two different ways; it is used to examine the significance of the
association (contingency) between the two kinds of classification.
Table-5 : Relationship between age of the participants and their BPACR status

n = 200

BPACR status Total df

Inadequa Statistical
Demographic Variables te Adequate value

Age of the <20 12 22 34 X2 = 5.934 4

participants
20-24 4 20 24 (5)

25-29 11 52 63 p value-
0.043
30-34 12 52 64

≥ 35 5 10 15

Total 44 156 200

*significant at 0.05 level of significance as p ≤ 0.05

Table 5 shows the relationship of age of the participants and BPACR status. Fishers
exact was used to test the relationship. There was a higher proportion of birth
preparedness and complication readiness among those whose age is between 30-34
than those whose age is ≥35. There was a statistically significant association between
age of the participants and their BPACR status as X2 (5) = 5.934, p value- 0.043
which is less than 0.05 level of significance with the degree of freedom 4.
 Relationship between age of the participants and their
BPACR status n = 200
60
52 52
50

40
Frequency

30
22
20
20
12 11 12
10
10 4 5

0
<20 20-24 25-29 30-34 ≥ 35
Age of the participants

BPACR status Inadequate BPACR status Adequate

Figure 1 : Relationship between age of the participants and their BPACR status
n = 200
Table-6: Relationship between marital status of the mother and their BPACR
status n = 200

BPACR status
Statistical
Demographic Variables inadequate adequate Total value df

Marital married 44 152 196 x2 = 1.151 3

Status of (5)
the mother Unmarri 0 1 1
ed p value -
0.078
widowed 0 1 1

divorcee 0 2 2

Separate 0 0 0
d

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 6 shows the relationship of age of the marital status and BPACR status. Fishers
exact was used to test the relationship. There was a higher proportion of birth
preparedness and complication readiness among those who are married. There was no
statistically significant association between age of the marital status and their BPACR
status as x2 (5) = 1.151, p value- 0.078 which is more than 0.05 level of significance
with the degree of freedom 3.
 Relationship between marital status of the mother and
their BPACR status n = 200
160 152

140
120
Frequency

100
80
60 44
40
20 1 1 2
0 0 0 0 0
0
married Unmarried widowed divorcee Separated
Marital Status of the mother

BPACR status inadequate BPACR status adequate

Figure 2:- Relationship between marital status of the mother and their BPACR
status n = 200
Table- 7: Relationship between education of the mother and their BPACR status
n = 200

BPACR status

Demographic Inadequ Statistical

Variables ate Adequate Total Value df

Educatio Illiterate 5 8 13 X 2 = 1.652 4

n of the
mother Primary 6 22 28
Education
p value=
Secondary 10 40 50 0.037
Education

Senior 8 32 40
Secondary
Education

graduate 15 54 69

Post-gradu 0 0 0
ate

Total 44 156 200

*significant at 0.05 level of significance as p< 0.05

Table 7 shows the relationship of education of the mother and BPACR status. Fishers
exact was used to test the relationship. There was a higher proportion of birth
preparedness and complication readiness among those who were graduate. There was
a statistically significant association between education of the mother and their
BPACR status as x2 (5) = 1.652 , p value- 0.037 which is less than 0.05 level of
significance with the degree of freedom 4.
 Relationship between education of the mother and their
BPACR status n = 200
60 54
50
40
40
Frequency

32
30
22
20 15
8 10 8
10 5 6

Education of the mother

BPACR status Inadequate BPACR status Adequate

Figure 3 :- Relationship between education of the mother and their BPACR

status n = 200
Table-8: Relationship between parity of the mother and their BPACR score
n = 200

BPACR status Statistical

value
Demographic inadequ
Variables ate adequate Total df

Parity Nullipar 13 7 20 X2 = 3.538 3

ous
(5)
Para 1 13 52 65
p value-
Para 2 19 80 99 0.027

Para > 2 5 11 16

Total 44 156 200

*significant at 0.05 level of significance as p ≤ 0.05

Table 8 shows the relationship of parity of the antenatal mothers and BPACR status.
Pearson chi-square was used to test the relationship. There was a higher proportion of
birth preparedness and complication readiness among those who were para 2 than
those who were nulliparous. There was a statistically significant association between
age of the participants and their BPACR status as x2 (5) = 3.538, p value- 0.027 which
is less than 0.05 level of significance with the degree of freedom 3.
 Relationship between parity of the mother and their
BPACR score n = 200
90
80
80
70
60 52
Frequency

50
40
30
19
20 13 13 11
7 5
10
0
Nulliparous Para 1 Para 2 Para > 2
Parity

BPACR status inadequate BPACR status adequate

Figure 4 : Relationship between parity of the mother and their BPACR score
n = 200
Table-9: Relationship between type of family of the mother and their BPACR
status n = 200

BPACR status

Demographic inadequ Statistical

Variables ate adequate Total value df

Type of Nuclear 23 71 94 x2 = 2.265 2

family
Joint 17 77 94 (5)

Extende 4 8 12 P
d value-0.738

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 9 shows the relationship of type of family of the antenatal mothers and BPACR
status. Fishers exact was used to test the relationship. There was a higher proportion
of birth preparedness and complication readiness among those who were in joint
family those who were nuclear family. There was no statistically significant
association between type of family of antenatal mothers and their BPACR status as x2
(5) = 2.265 , p value- 0.738 which is more than 0.05 level of significance with the
degree of freedom 2.
 Relationship between type of family of the mother and
their BPACR status n = 200
90
77
80 71
70
60
Frequency

50
40
30 23
17
20 8
10 4
0
Nuclear Joint Extended
Type of family

BPACR status inadequate BPACR status adequate

Figure 5 :- Relationship between type of family of the mother and their BPACR
status n = 200
Table- 10 : Relationship between residential area of the mother and their
BPACR status n = 200

BPACR status

Demographic Inadequat Adequat Statistical

Variables e e Total Value df

Residential Urban 13 30 43 x2 = 2.894 3

Area Area
P value-
Rural 5 23 28
0.420
Area

Sub 26 103 129

urban
area

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 10 shows the relationship of residential area of the antenatal mothers and
BPACR status. Pearson chi-square was used to test the relationship. There was a
higher proportion of birth preparedness and complication readiness among those who
were residing in suburban area. There was no statistically significant association
between type of family of antenatal mothers and their BPACR status as x2 (5) = 2.894
, p value- 0.420 which is more than 0.05 level of significance with the degree of
freedom 3.
 Relationship between residential area of the mother and
their BPACR status n = 200
120
103
100

80
Frequency

60

40 30 26
23
20 13
5
0
Urban Area Rural Area Sub urban area
Residential Area

BPACR status inadequate BPACR status adequate

Figure 6:- Relationship between residential area of the mother and their BPACR
status n = 200
Table- 11: Relationship between occupation of the husband and their BPACR
status n = 200

BPACR Status Total

Demographic Inadequ Statistical

Variables ate Adequate value df

Occupation Unempl 1 0 1 x2 = 5.838 3

of the oyed
P value-
Husband
Self-em 15 53 68
0.105
ployed

Govern 6 40 46
ment
service

Private 22 63 85
service

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 11 shows the relationship of occupation of husbands of the antenatal mothers

and BPACR status. Fishers exact was used to test the relationship. There was a higher
proportion of birth preparedness and complication readiness among those who were in
private service. There was no statistically significant association between occupation
of husbands of antenatal mothers and their BPACR status as x2 (5) = 5.838 , p value-
0.105 which is more than 0.05 level of significance with the degree of freedom 3.
 Relationship between occupation of the husband and their BPACR
status n = 200
70
60
50
40
30
20
10
0
Unemployed Self-employed Government service Private service
Occupation of the Husband

Inadequate adequate

Figure 7: Relationship between occupation of the husband and their BPACR

status n = 200
Table-12: Relationship between previous still birth of the mother and their
BPACR status n = 200

BPACR Status

Demographic inadequa
Variables te adequate Total r value df

Previous yes 1 4 5 x2 = 4.518 3

still birth
P value-
No 41 154 195 0.165

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 12 shows the relationship of the antenatal mothers having previous still birth
and BPACR status. Fishers exact was used to test the relationship. There was a higher
proportion of birth preparedness and complication readiness among those who did not
have had any previous still birth. There was no statistically significant association
between previous still birth and their BPACR status as x2 (5) = 4.518 , p value- 0.165
which is more than 0.05 level of significance with the degree of freedom 3.
 Relationship between previous still birth of the mother
and their BPACR status n = 200
180
154
160
140
120
Frequency

100
80
60 41
40
20 1 4
0
yes No
Previous still birth

inadequate adequate

Figure 8 : Relationship between previous still birth of the mother and their
BPACR status n = 200
Table-13: Relationship between occupation of the mother and their BPACR
status n = 200

BPACR Status

Demographic inadequ Statistical

Variables ate adequate Total value df

Occupatio Housewif 31 116 147 x2 = 1.796

n of the e
P value- 3
mother
Labourer 3 5 8
0.480
Self-empl 6 24 30
oyed

Governme 0 0 0
nt service

Private 4 11 15
service

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 13 shows the relationship of occupation of the mothers and their BPACR status.
Fishers exact was used to test the relationship. There was a higher proportion of birth
preparedness and complication readiness among those who were housewives. There
was no statistically significant association between occupation of the mother and their
BPACR status as x2 (5) = 1.796 , p value- 0.480 which is more than 0.05 level of
significance with the degree of freedom 3.
 Relationship between occupation of the mother and
their BPACR status n = 200
140
116
120

100
Frequency

80

60

40 31
24
20 11
3 5 6 4
0 0
0
Housewife Labourer Self-employed Government Private service
service
Occupation of the mother

BPACR Status inadequate BPACR Status adequate

Figure 9:- Relationship between occupation of the mother and their BPACR
status n = 200
Table- 14 : Relationship between religion of the mother and their BPACR status
n = 200

Demographic BPACR Status

Variables
Inadequ Adequat Statistical
ate e Total value df

Religion Hindu 41 149 190

Muslim 7 3 10 x2 = 0.393 1

Christian 0 0 0 P value-

Sikhism 0 0 0 0.531

Budhism 0 0 0

Jainism 0 0 0

Other 0 0 0
religion

Total 44 156 200

Not significant at 0.05 level of significance as p > 0.05

Table 14 shows the relationship of religion of the mothers and their BPACR status.
Fishers exact was used to test the relationship. There was a higher proportion of birth
preparedness and complication readiness among those who were hindu. There was no
statistically significant association between religion of the mother and their BPACR
status as x2 (5) = 0.393 , p value- 0.531 which is more than 0.05 level of significance
with the degree of freedom 1.
 Relationship between religion of the mother and their
BPACR status n = 200
160 149

140

120

100
Frequencyl

80

60
41
40

20 7 3 0 0 0 0 0 0 0 0 0 0
0
Hindu Muslim Christian Sikhism Budhism Jainism Other religion
Religion

BPACR Status Inadequate BPACR Status Adequate

Figure 10:- Relationship between religion of the mother and their BPACR status
n = 200
 CHAPTER - 5
DISCUSSION
This chapter deals with the summary of major findings of the study, conclusion,
discussion of the findings, implication for nursing education, nursing practice and
nursing administrations, followed by its limitations and recommendations for future
research in this field.

PART - A
Findings related to demographic characteristics of 200
antenatal mothers.

A total of 200 women participated in our study with no refusals. Table 1 depicts that the
mean age of the respondents was 24.2 years (standard deviation, SD 2.031) with nearly
equal numbers in age group 30-34 and 25-29. One third (1/3rd) of the study participants
belongs to the age group 30-34 i.e. 32 % and 25-29 i.e. 31.5%. 17%(34) of antenatal
mothers belongs to the age group <20 and 12%(24) belongs to the age group of 20-24
while merely 7.5% belongs to the age group ≥35.
Majority of the antenatal mothers were married i.e. 98% (196).

Almost 1/3rd(34.5%) subjects were graduate while 1/5 th (20%) subjects had
completed senior secondary education. One-fourth (25.0%) had completed secondary
education. 23 antenatal mothers were found to be illiterate (11.5%).

Almost half of the antenatal mothers (49.5%) were para 2. More than one third
(32.5%) were para 1 and only 20 were nulliparous i.e. 10%.

There were evident that antenatal mothers were equally distributed in terms of the
type of family they belong to i.e. 47% to nuclear and joint family.

More than half 63% antenatal mothers resides in suburban area and more than 1/4 th
(21.5%) resides in urban area while merely 14% resides in rural area.
Table also shows that nearly half of the participant’s husband ( 42.5%) were in private
service. More than one-third were self-employed(34%) while 23% were in
government service.

Majority of antenatal mothers did not experience still birth previously i.e. 97.5%
(195) while 2.5%(5) have had a still birth previously.

Most of the antenatal mothers 73.5% (147) were housewives, 15% were
self-employed , 7.5% were in private service and 4% were laborers.

Majority of antenatal mothers were hindu i.e 95%(195) and only 5% were muslims.

PART - B
Section I:- Findings related to BPACR Score

Results shows that most of the antenatal mothers out of 7 scored 4 i.e 21%(42),
18.5%(37) scored 3, 14%(28) scored 5, 13.5% scored 6/7, 11.5% (23) scored 7, 9%
scored 0, 7% scored 2 and 5.5% scored 1 out of 7. It could be inferred by the following
data that one-fourth of the antenatal mothers had scored 4 out of 7.

PART - B
Section II:- Findings related to BPACR status

BPACR status of 156 antenatal mothers i.e. 78% was adequate and 22% (44) was found
to be inadequate.
(JHPIEGO. Maternal and Neonatal health (MNH) Program, Birth preparedness and
complication readiness. A matrix of shared responsibilities. Maternal and Neonatal
Health. 2001)

BPACR index was calculated as Σ Indicator/7, which was 55.7%. Table 4 shows
BPACR indicators among study participants. After all the seven indicators calculated
with their respective percentages BPACR was 55.7%.
 PART - B
Section III:- Findings related to relationship of Birth
preparedness and Complication Readiness (BPACR) in
antenatal mothers with selected demographic variables
There was a higher proportion of birth preparedness and complication readiness
among those whose age is between 30-34 than those whose age is ≥35. There was a
statistically significant association between age of the participants and their BPACR
status as X2 (5) = 5.934, p value- 0.043 which is less than 0.05 level of significance
with the degree of freedom 4.

here was a higher proportion of birth preparedness and complication readiness among
those who are married. There was no statistically significant association between age
of the marital status and their BPACR status as x2 (5) = 1.151, p value- 0.078 which is
more than 0.05 level of significance with the degree of freedom 3.

here was a higher proportion of birth preparedness and complication readiness among
those who were graduate. There was a statistically significant association between
education of the mother and their BPACR status as x2 (5) = 1.652 , p value- 0.037
which is less than 0.05 level of significance with the degree of freedom 4.
There was a higher proportion of birth preparedness and complication readiness
among those who were para 2 than those who were nulliparous. There was a
statistically significant association between age of the participants and their BPACR
status as x2 (5) = 3.538, p value- 0.027 which is less than 0.05 level of significance
with the degree of freedom 3.

There was a higher proportion of birth preparedness and complication readiness

among those who were in joint family those who were nuclear family. There was no
statistically significant association between type of family of antenatal mothers and
their BPACR status as x2 (5) = 2.265 , p value- 0.738 which is more than 0.05 level of
significance with the degree of freedom 2.

There was a higher proportion of birth preparedness and complication readiness

among those who were residing in suburban area. There was no statistically
significant association between type of family of antenatal mothers and their BPACR
status as x2 (5) = 2.894 , p value- 0.420 which is more than 0.05 level of significance
with the degree of freedom 3.
here was a higher proportion of birth preparedness and complication readiness among
those who were in private service. There was no statistically significant association
between occupation of husbands of antenatal mothers and their BPACR status as x2
(5) = 5.838 , p value- 0.105 which is more than 0.05 level of significance with the
degree of freedom 3.

here was a higher proportion of birth preparedness and complication readiness among
those who did not have had any previous still birth. There was no statistically
significant association between previous still birth and their BPACR status as x2 (5) =
4.518 , p value- 0.165 which is more than 0.05 level of significance with the degree of
freedom 3.

There was a higher proportion of birth preparedness and complication readiness

among those who were housewives. There was no statistically significant association
between occupation of the mother and their BPACR status as x2 (5) = 1.796 , p value-
0.480 which is more than 0.05 level of significance with the degree of freedom 3.

There was a higher proportion of birth preparedness and complication readiness

among those who were hindu. There was no statistically significant association
between religion of the mother and their BPACR status as x2 (5) = 0.393 , p value-
0.531 which is more than 0.05 level of significance with the degree of freedom 1.

DISCUSSION

BPACR is a strategy to promote the timely use of skilled maternal and neonatal care,
especially during childbirth, based on the theory that preparing for childbirth reduces
delays in obtaining this care. Despite the great potential of BPACR in reducing the
maternal and newborn deaths its status is not known. In our study, overall level of
awareness regarding danger signs of pregnancy was very low (27.8%), followed by
poor awareness of danger signs of labor (4.7%), were as only (4.4%) women knew
about danger signs during puerperium. Regarding the awareness during antenatal care
89.3% were aware towards immunization against tetanus, while 47% were aware
about registration during 1st trimester. 83% of women had identified a skilled
attendant for birth which is similar to a multicentric study conducted in Nigeria [7],
where it was reported that awareness of the concept of birth preparedness was high
(70.6%) but knowledge of specific

Table 5 shows the factors associated with BPACR among pregnant women attending
PHC. The variables are independently associated with birth plan. Factors like age and
religion shows no positive association with BPACR. While SES class IV shows a
positive association. Secondary level of education of study participants shows a three
times positive association with BPACR, similarly husbands who are educated to
secondary or graduate level shows a positive association. Immunization against
tetanus only shows a positive association among antenatal care.

danger signs was poor.In another study done in Nigeria [8], similar results regarding
poor awareness of danger signs (28.3%) were reported. A study conducted among
pregnant and recently delivered mothers in Rewa district of Madhya Pradesh also
highlighted similar findings where BPACR index was found to be 41% [9]. This study
revealed poor level of knowledge about key danger signs and transportation services
among mothers. Knowledge about financial assistance was high. The study showed
that majority of the women had planned for skilled provider and transport but less
than half (44.2%) of the mothers planned for saving money which is nearly similar to
our study results. A field trial conducted in the neighboring country of Nepal [4]
concluded that birth preparedness programs could positively influence knowledge and
intermediate health outcomes, such as household practices and use of some health
services. It was recommended that such programs can be implemented by government
health services with minimal outside assistance but should be comprehensively
integrated into the safe motherhood program rather than implemented as a separate
intervention. In a study conducted in 11 slums of Indore [10], it was reported that less
than half of the mothers (47.8%) were well- prepared. Although awareness of the
mothers about at least one danger-sign of pregnancy and delivery was not low, being
79.2% and 78.5%, respectively; however, nearly three-fourths of the deliveries took
place in the home. Overall, only 32% of the deliveries were attended by skilled birth
attendants. In a study conducted in PHC of Delhi [11], the results are similar to our
study where BPACR was 44%, but in few aspects like awareness about danger
signals, husbands role our study shown better results. Our study showed that SES
class IV, education, husband’s education and immunization against tetanus were
associated with having a birth plan. Woman’s education (P = 0.001) and her spouse’s
education (P = 0.02) up to graduate and above were strong predictors of BPACR
which is similar to a study done in rural Uganda where women’s education and her
spouse’s education are significantly associated with BPACR [12]and astudy done in
Kenya [13] also reported women’s education having positive influence on birth
preparedness. The finding of low preference for the government health facilities
during obstetric emergencies in the present study highlights the need for making
efforts to improve the quality of care in the government facilities.

Due to better health information Educated women have better pregnancy outcome
compared with uneducated women, are likely to make better choices, develop and
implement a birth plan, and are more socially or financially empowered to make the
necessary decisions in case of obstetric emergencies [14]. Our findings are in
agreement with others [15] that many patients are admitted when they already have
life threatening complications. This is a reflection of the quality of antenatal care at
peripheral units, the quality of obstetric care at the referring units and the efficiency of
the referral system. The finding that many of the referrals were in critical condition at
admission suggests possible delays in making the decision to refer (possibly due to
difficulty in diagnosis), delays in reaching the referral hospital or poor quality of care
at the referring health facility. Indeed, diagnostic delays and misdiagnosis are
responsible for many of the near-miss mortality and are common among emergency
obstetric referrals [16,17].

CONCLUSION

As the level of awareness regarding BPACR is low i.e. 55.7%. in 200 antenatal
mothers need to be empowered to contribute positively to make pregnancy safer.
There are many strategies that have been devised to reduce maternal mortality in India
and one has been implementation of birth preparedness strategy. Studies have shown
that birth preparedness has positive influence in reduction of maternal mortality.The
main objective of this study was to assess the Birth preparedness and Complication
Readiness status among antenatal mothers who are attending ANC clinic of primary
health centers of New Delhi.This can be done by raising awareness towards
improving education for women.Antenatal care provides a golden opportunity to all
the pregnant women to provide information, education and communication so that
they along with their families can make the correct choices especially in event of any
complications arising during delivery, childbirth or post-partum. This opportunity is
missed many a times due to a number of reasons which should be addressed at the
individual, family, community and the health provider’s level. Repeated IEC
awareness programs may be initiated at the PHC towards community participation so
that BPACR status improves for these women. This will be a positive step toward
achieving the millennium development goal 5 of safe motherhood and reduction in
maternal mortality.

NURSING RESEARCH

Nurses are very well into the research but mixed approaches research remains an area
less explored by them and for real and ground level understanding of some important
issues of human life.

Similar studies can be replicated in another setting with another group of clients so as
to generate more valid and reliable data.

LIMITATIONS

Time duration was less to study the phenomenon for a long period of time.

-Generalization cannot be made as the sample size is small.

-Obtaining the desired sample within a limited time period was a little difficult for the
researcher.
-Difficulty in getting the time of subjects as they were busy with their antenatal
checkup and investigations.

Strong points of the study

-Study was conducted in natural setting.

-In-depth interview schedule was developed with a number of trigger so as to prevent
data loss.
-Considerable sample size for the study.
-Various initiatives were taken to ensure the trustworthiness of data e.g. data were
collected by interview schedules.
-Information Booklet was disseminated related to Birth Preparedness and
Complication Readiness in antenatal mothers.
RECOMMENDATIONS

Based on the results of this study the following recommendations have been made;

1. The ministry of health should do a sensitization on birth preparedness among

women of reproductive age.

2. The ministry of health should improve the level of birth preparedness through

quality ante natal care.

3. The government through all relevant ministries should put in place strategies

to increase the average income of the women and households.

4. The ministry of health should upscale the attendance of ante natal care to a

minimum of four visits per pregnancy.

5.The study can be replicated in different settings with larger samples.

6.A comparative study can be done with different setting.

7.A longitudinal study can be done for a longer span of time so as to understand the
phenomenon with more holistic approach.
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