Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda: a quasi-experiment study

Rornald Muhumuza Kananura; Moses Tetui; John Bua; Elizabeth Ekirapa-Kiracho; Aloysius Mutebi; Gertrude Namazzi; Suzanne Namusoke Kiwanuka; Peter Waiswa

doi:10.1080/16549716.2017.1362826

Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda: a quasi-experiment study

Glob Health Action. 2017 Aug;10(sup4):1362826. doi: 10.1080/16549716.2017.1362826.

Authors

Rornald Muhumuza Kananura^{1

2}, Moses Tetui^{1

3}, John Bua¹, Elizabeth Ekirapa-Kiracho¹, Aloysius Mutebi¹, Gertrude Namazzi^{1

2}, Suzanne Namusoke Kiwanuka³, Peter Waiswa^{1

2

4}

Affiliations

¹ a Department of Health Policy Planning and Management , Makerere University School of Public Health , Kampala , Uganda.
² c Makerere University Centre of Excellence for Maternal and Newborn Health Research , Kampala , Uganda.
³ b Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine Umeå University , Umeå , Sweden.
⁴ d Global Health Division, Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.

Abstract

Background: Knowledge of obstetric danger signs and adequate birth preparedness (BP) are critical for improving maternal services utilization.

Objectives: This study assessed the effect of a participatory multi-sectoral maternal and newborn intervention on BP and knowledge of obstetric danger signs among women in Eastern Uganda.

Methods: The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study was implemented in three districts from 2013 to 2015 using a quasi-experimental pre-post comparison design. Data were collected from women who delivered in the last 12 months. Difference-in-differences (DiD) and generalized linear modelling analysis were used to assess the effect of the intervention on BP practices and knowledge of obstetric danger signs.

Results: The overall BP practices increased after the intervention (DiD = 5, p < 0.05). The increase was significant in both intervention and comparison areas (7-39% vs. 7-36%, respectively), with a slightly higher increase in the intervention area. Individual savings, group savings, and identification of a transporter increased in both intervention and comparison area (7-69% vs. 10-64%, 0-11% vs. 0-5%, and 9-14% vs. 9-13%, respectively). The intervention significantly increased the knowledge of at least three obstetric danger signs (DiD = 31%) and knowledge of at least two newborn danger signs (DiD = 21%). Having knowledge of at least three BP components and attending community dialogue meetings increased the odds of BP practices and obstetric danger signs' knowledge, respectively. Village health teams' home visits, intervention area residence, and being in the 25+ age group increased the odds of both BP practices and obstetric danger signs' knowledge.

Conclusions: The intervention resulted in a modest increase in BP practices and knowledge of obstetric danger signs. Multiple strategies targeting women, in particular the adolescent group, are needed to promote behavior change for improved BP and knowledge of obstetric danger signs.

Keywords: Uganda; birth preparedness; implementation science; maternal obstetric danger signs; quasi-experimental study.

Publication types

Clinical Study

MeSH terms

Adolescent
Adult
Community Health Workers / organization & administration
Female
Health Knowledge, Attitudes, Practice*
House Calls
Humans
Infant, Newborn
Maternal Health Services
Mothers / education*
Parturition
Patient Education as Topic / organization & administration*
Pregnancy
Prenatal Care / organization & administration*
Uganda
Young Adult

Grants and funding

The study was funded by Comic Relief (grant number GR0002-12588). In addition, Future Health Systems through a grant from the Department for International Development (DfID) provided additional funding for the publication process of this paper.