Determinants of Birth Preparedness and Complication Readiness among Tribal Pregnant Women in Maharashtra: A...

Maternal and neonatal health remains a public health priority, especially in marginalized tribal populations where maternal morbidity and mortality are disproportionately high due to the socio-cultural barriers and limited healthcare access. The Birth Preparedness and Complication Readiness (BPACR) index is used to assess the readiness of pregnant women and their families to handle complications, but its applicability in tribal regions needs further investigation. To assess knowledge, attitude, and practice (KAP) regarding BPACR among pregnant women in a tribal region of Maharashtra and to explore the relationships between KAP and BPACR scores using structural equation modelling (SEM).

A cross-sectional survey was conducted among 384 pregnant women from tribal areas of Maharashtra. The BPACR questionnaire assessed observed and latent KAP variables. SEM with confirmatory factor analysis (CFA) explored associations between variables such as education, income, age at marriage, and KAP. Model fit was evaluated using χ², comparative fit index (CFI), Tucker-Lewis Index (TLI), root-mean-square error of approximation (RMSEA), and standardized root mean square residual (SRMR).

The SEM model showed excellent fit (CFI = 0.996, RMSEA = 0.025, SRMR = 0.021). Knowledge and practice were significant predictors of BPACR scores, with higher knowledge of maternal health and antenatal care associated with better preparedness. Socio-demographic factors like education also significantly influenced BPACR scores.

Improving knowledge and practices around maternal health enhances birth preparedness among tribal women. Targeted education and health promotion interventions are essential to address the unique challenges faced by these communities, with a focus on overcoming socio-cultural barriers.