Maternal preparedness for uptake of newborn hepatitis B immunoprophylaxis at birth: Implications for preventing mother-to-child transmission in resource-limited settings.

OBJECTIVES: Hepatitis B virus (HBV) remains a major public health challenge in sub-Saharan Africa, with mother-to-child transmission (MTCT) being the dominant route of infection. Timely administration of combined immunoprophylaxis HBV vaccine and hepatitis B immunoglobulin within 24 hours of birth is critical for prevention. However, maternal readiness to facilitate this intervention is poorly documented in Ghana. The study aimed to assess maternal preparedness for uptake of HBV immunoprophylaxis for exposed newborns in Northern Ghana and to identify associated predictors.

METHODS: A cross-sectional study was conducted among 118 hepatitis B surface antigen-positive pregnant women attending antenatal care in 10 health facilities. Data were collected using a structured 10-item preparedness scale (α >0.70) and analyzed using SPSS v23. Descriptive statistics, chi-square tests, analysis of variance and multivariable logistic regression were applied to identify differences in preparedness scores across variables and predictors of preparedness.

RESULTS: The mean preparedness score was 3.29 (SD = 0.70) reflecting an overall response between 'agree' and 'strongly agree' on the 5-point Likert scale. Based on percentage scores derived from the composite preparedness scale, 72% of women demonstrated high preparedness, while 28% were moderately prepared. None had poor preparedness. Preparedness was highest for perceived importance of immunoprophylaxis (M = 3.81) and knowledge of MTCT (M = 3.70). Lower mean scores were observed for financial readiness (M = 2.36) and adequacy of information from health providers (M = 2.57). Preparedness varied significantly by income category (P = 0.032) and family history of HBV (P = 0.042). Multivariable analysis showed tertiary education was negatively associated with preparedness (adjusted odds ratio = 0.13, 95% confidence interval: 0.02-0.76).

CONCLUSIONS: Maternal preparedness for HBV immunoprophylaxis in Northern Ghana was high, reflecting good awareness of MTCT prevention. However, financial constraints and insufficient provider information remain key barriers. Income-related differences highlight the need for cost-reduction strategies, while the negative association with tertiary education warrants further investigation. Strengthening antenatal counseling and integrating hepatitis B immunoglobulin into national financing schemes could improve equitable uptake and support HBV MTCT elimination efforts.