Effect of post-discharge postnatal educational intervention on postnatal practices among lowincome primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment
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Date
2024-05
Authors
Kamau, Immaculate Wambui
Keraka, Margaret Nyanchoka
Gitonga, Eliphas
Journal Title
Journal ISSN
Volume Title
Publisher
Medical Journal
Abstract
Introduction: informal settlements exhibit
disproportionately worse maternal and newborn
outcomes. Postnatal care (PNC) is a high-impact
intervention for populations contributing to higher
mortalities. Postnatal education is crucial to
adopting evidence-based postnatal practices
(PNPs) thus its post-discharge reinforcement is
vital for low-income primiparas. This study aimed
to determine the effect of post-discharge follow-up
postnatal education intervention (PNE) on the
adoption of recommended PNPs among lowincome primiparas. Methods: quasi-experimental
study in Nairobi informal settlements with 118
primiparas discharged early after normal delivery
on each arm. Facility and demographic data
collected using an interviewer-administered
questionnaire. Study arm received the intervention
for 6 weeks in addition to routine PNC while
control received routine PNC only. An intervieweradministered exit questionnaire applied after 6
weeks. Focus group discussions conducted for
qualitative data then analyzed thematically. SPSS
used to analyze quantitative data then descriptive
statistics, t-tests, Chi-square, Mann-Whitney, and
multiple linear or logistic regressions derived.
PNPs composed of health-seeking for maternal
and newborn danger signs, self and baby
care practices, and utilization of PNC contacts.
Results: the intervention was a positive predictor
of adoption of composite PNPs (β=0.26, p=0.00),
self-care practices (β=0.39, p=0.00) and mothers'
two weeks PNC contact (OR=4.64, p=0.00, 95%
CI=1.9-11.2). Neither a significant predictor of
health-seeking for maternal (β=-0.11, p=0.31) nor
newborns danger signs (β=-0.04, p=0.73) though
inversely related. No influence on baby care
practices, two weeks newborn contact and six
weeks contact for the dyad. Multi-pronged
approaches appreciated. Conclusion: follow-up
post-discharge PNE intervention enhances
adoption of PNPs among low-income primiparas
thus a worthwhile supplement to routine PNC.
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Citation
Kamau, I. W., Keraka, M. N., & Gitonga, E. Effect of post-discharge postnatal educational intervention on postnatal practices among low-income primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment.