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Bridging the Know–Do Gap: Integration of Obstetric Emergency Knowledge and Care-Seeking Readiness among Pregnant Women in Ilorin, Nigeria
Subject area: Biological & Medical Sciences · Area of research: Maternal Health
DOI: 10.64388/IREV10I4-1724129
Abstract
In Nigeria, there has been a rising awareness among pregnant women about danger signs, but they are still arriving at health facilities at the last minute. This paper combines both the quantitative and the qualitative aspects of a sequential explanatory mixed methods research to explain the difference between the knowledge and action of pregnant women who attended antenatal care services in Ilorin, Kwara State. Three hundred and eleven women, selected by multi-stage sampling procedures, were surveyed at a teaching hospital and a cottage hospital and qualitative data were obtained through in-depth interviews with 20 respondents. Each of the survey indicators of recognition, intended first recourse, sources of information, decision making, travel time and financial readiness was compared to four themes of the interview and each of the comparisons was evaluated as confirmation, expansion or discordance. While 90.7% of women correctly identified an obstetric emergency, only 41.5% identified facial or leg swelling as a danger sign, while 25.7% would initially go to a chemist or a traditional birth attendant or stay at home, or pray at a prayer house. Only 10.3% had the ability to choose to go to a health care provider independently, 60.8% reported no health insurance and 60.8% reported no knowledge of costs in the event of an emergency. The explanations of these figures through interviews were spiritual attribution of complications, herbal first-line remedies, husband's authority, elders' authority, cash deposits and lack of night transportation. There was discordance in decision making – the majority of women who reported “joint” decisions said that they needed their husband's permission to make decisions, which means that surveys underestimate gatekeeping. Readiness to act, rather than knowledge, is the weak link. Antenatal programmes should be family based, include spiritual explanations and include support for emergency transport and financial protection.
Keywords
antenatal care; emergency obstetric care; know–do gap; mixed methods; Three Delays
References
[1] World Health Organization. Trends in maternal mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization; 2023.
[2] Thaddeus S, Maine D. Too far to walk: Maternal mortality in context. Social Science & Medicine. 1994;38(8):1091–1110. https://doi.org/10.1016/0277-9536(94)90226-7
[3] Ohenhen V, Oshomoh SA, Akpojaro E, Enobakhare E, Ovenseri C, Eboreime E. Birth preparedness and complication readiness: Evaluating the “know-do” gap among women receiving antenatal care in Benin City, Nigeria. Journal of Biosocial Science. 2023;55(6):1086–1100. https://doi.org/10.1017/S0021932022000475
[4] Famutimi EO, Olagunju OS, Olajide AO, Adejumo PO. Knowledge and perception of obstetric danger signs among antenatal women in Oyo West Local Government Area, Nigeria: A cross-sectional study. Journal of Nursing Reports in Clinical Practice. 2026;4(5):287–297. https://doi.org/10.32598/JNRCP.2026.1369
[5] Ilo IJ, Okolie S, Ndubuka CC, Ehiemere IO, Ekechukwu END. Factors preventing translation of knowledge to practice of birth preparedness and complication readiness among expectant mothers in Oji-River, Enugu. Teikyo Medical Journal. 2022;45(9):7421–7430.
[6] Onoh RC, Egede JO, Lawani LO, Ekwedigwe KC, Aja LO, Anozie BO. Birth preparedness and complication readiness among women of reproductive age group in Abakaliki, Southeast Nigeria. Nigerian Journal of Clinical Practice. 2020;23(3):362–370. https://doi.org/10.4103/njcp.njcp_670_18
[7] Opara UC, Iheanacho PN, Petrucka P. Cultural and religious structures influencing the use of maternal health services in Nigeria: A focused ethnographic research. Reproductive Health. 2024;21:188. https://doi.org/10.1186/s12978-024-01933-8
[8] Oguntunde O, Nyenwa J, Yusuf F, Dauda AG, Oyeniyi R, Findley S. Factors associated with the knowledge of obstetric danger signs, and perceptions of the need for obstetric care amongst married young women in northern Nigeria. African Journal of Primary Health Care & Family Medicine. 2021;13(1):a2557. https://doi.org/10.4102/phcfm.v13i1.2557
[9] Rosenstock IM. Historical origins of the health belief model. Health Education Monographs. 1974;2(4):328–335. https://doi.org/10.1177/109019817400200403
[10] Airhihenbuwa CO. Health and culture: Beyond the Western paradigm. Thousand Oaks, CA: Sage; 1995.
[11] Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd ed. Thousand Oaks, CA: Sage; 2018.
[12] Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs—principles and practices. Health Services Research. 2013;48(6 Pt 2):2134–2156. https://doi.org/10.1111/1475-6773.12117
[13] Cochran WG. Sampling techniques. 3rd ed. New York: John Wiley & Sons; 1977.
[14] Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa
[15] Oni OO, Bello OO, Ajayi AA. Determinants of adequate knowledge of postpartum warning signs and complications among parturients in Ibadan, Nigeria: A cross sectional study. BMC Pregnancy and Childbirth. 2025;25:894. https://doi.org/10.1186/s12884-025-08058-1
[16] Uwiringiyimana E, et al. Pregnant women’s knowledge of obstetrical danger signs: A cross-sectional survey in Kigali, Rwanda. PLOS Global Public Health. 2022;2(11):e0001084. https://doi.org/10.1371/journal.pgph.0001084
[17] Mustapha AA, Akpor OA, Muhammad F. Religion and pregnancy: Post-partum mothers religious beliefs and practices in an urban area in Southwestern Nigeria. Annals of the Romanian Society for Cell Biology. 2021;25(4):4692–4702.
[18] Biralo PK, Nnadi NO, Uriah SS, Dan-Jumbo A. Religion, socio-cultural factors and maternal mortality in Bori, Ogoni, Rivers State. Greener Journal of Medical Sciences. 2023;13(2):126–132. https://doi.org/10.15580/GJMS.2023.2.091123103
[19] Felisian S, Mushy SE, Tarimo EA, Kibusi SM. Sociocultural practices and beliefs during pregnancy, childbirth, and postpartum among indigenous pastoralist women of reproductive age in Manyara, Tanzania: A descriptive qualitative study. BMC Women’s Health. 2023;23:123. https://doi.org/10.1186/s12905-023-02277-4
[20] Olowolafe AS, Eleojo YM, Oladoyinbo OT, Ademola SA, Abdullahi LA, Kalesanwo EO. Factors influencing husband’s involvement in birth preparedness and complication readiness among women attending ante-natal clinic in General Hospital Alloma, Ofu Local Government Area, Kogi State. International Journal of Research Publication and Reviews. 2023;4(10):21–29.
[21] Yemata GA, Dessibellew G, Alle A, Tafere Y, Bayabil AW, Dagnaw EH. Husband participation in birth preparedness and complication readiness and its predictors among men whose wife was admitted for an obstetric referral at South Gondar zone: A multicenter cross-sectional study. Heliyon. 2023;9(5):e15348. https://doi.org/10.1016/j.heliyon.2023.e15348
[22] Aguma OC, Ihudiebube-Splendor CN, Altraide OB, Peretomode E. Birth preparedness and complication readiness knowledge and practice among pregnant women in selected primary health care centers in Port Harcourt, Rivers State. African Journal of Health, Nursing and Midwifery. 2020;3(4):23–34.
[23] Shewiyo EJ, Manongi R, Mahande MJ. Does knowledge of danger signs influence use of maternal health services among rural women? Findings from Babati Rural district, Northern Tanzania. PAMJ One Health. 2021;4:4. https://doi.org/10.11604/pamj-oh.2021.4.4.25206
How to cite this paper
@article{1724129,
author = {Monsurat Adebimpe Olaniyan, Goodman John Ani, Chijioke Ogodo Ogeh},
title = {Bridging the Know–Do Gap: Integration of Obstetric Emergency Knowledge and Care-Seeking Readiness among Pregnant Women in Ilorin, Nigeria},
journal = {Iconic Research And Engineering Journals},
year = {2026},
volume = {10},
number = {4},
pages = {2881-2889},
issn = {2456-8880},
url = {https://www.irejournals.com/formatedpaper/1724129.pdf},
abstract = {In Nigeria, there has been a rising awareness among pregnant women about danger signs, but they are still arriving at health facilities at the last minute. This paper combines both the quantitative and the qualitative aspects of a sequential explanatory mixed methods research to explain the difference between the knowledge and action of pregnant women who attended antenatal care services in Ilorin, Kwara State. Three hundred and eleven women, selected by multi-stage sampling procedures, were surveyed at a teaching hospital and a cottage hospital and qualitative data were obtained through in-depth interviews with 20 respondents. Each of the survey indicators of recognition, intended first recourse, sources of information, decision making, travel time and financial readiness was compared to four themes of the interview and each of the comparisons was evaluated as confirmation, expansion or discordance. While 90.7% of women correctly identified an obstetric emergency, only 41.5% identified facial or leg swelling as a danger sign, while 25.7% would initially go to a chemist or a traditional birth attendant or stay at home, or pray at a prayer house. Only 10.3% had the ability to choose to go to a health care provider independently, 60.8% reported no health insurance and 60.8% reported no knowledge of costs in the event of an emergency. The explanations of these figures through interviews were spiritual attribution of complications, herbal first-line remedies, husband's authority, elders' authority, cash deposits and lack of night transportation. There was discordance in decision making – the majority of women who reported “joint” decisions said that they needed their husband's permission to make decisions, which means that surveys underestimate gatekeeping. Readiness to act, rather than knowledge, is the weak link. Antenatal programmes should be family based, include spiritual explanations and include support for emergency transport and financial protection.},
keywords = {antenatal care; emergency obstetric care; know–do gap; mixed methods; Three Delays},
month = {October},
doi = {https://doi.org/10.64388/IREV10I4-1724129}
}