Saaka Mahama, Aryee Paul, Kuganab-Lem Robert, Ali Mohammed, Masahudu Abdul Razak
School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana.
2Catholic Relief Services (Ghana) Program, Tamale, Ghana.
Global Health. 2017 Mar 21;13(1):19. doi: 10.1186/s12992-017-0243-7.
An understanding of maternal knowledge of the danger signs of obstetric and newborn complications is fundamental to attaining universal health coverage. In Northern Ghana, where maternal and newborn morbidity and mortality is high, little is known about the current knowledge level and associated determinants of these danger signs. This study assessed the effect of social behavior change communication (SBCC) package on knowledge of obstetric and newborn danger signs among mothers with children under 24 months of age.
This study used a non-randomized controlled community-based intervention design with pre and post-intervention household surveys in the intervention and comparison communities of the East Mamprusi District in Ghana. The study population were selected using a two-stage cluster sampling procedure.
Only 521 (51.1%), 300 (29.4%) and 353 (34.6%) of the study participants knew at least three key danger signs during pregnancy, delivery and postpartum period respectively. The intervention had a positive effect on maternal knowledge of danger signs. Compared to their counterparts in the comparison communities, women in the intervention communities were about 2.6 times (AOR = 2. 58 [CI: 1.87, 3.57]), 3.4 times (AOR = 3.39 [CI: 2.31, 4.96]) and 2.2 times (AOR = 2.19 [CI: 1.68, 2.84]) more likely to have higher knowledge of danger signs of childbirth, postpartum and neonate, respectively. Having sought postnatal services at least once was significantly associated with the mentioning of at least three danger signs of postpartum (AOR = 3.90 [CI: 2.01, 7.58]) and childbirth (AOR = 1.75 [CI: 1.06, 2.85]).
There was a significant contribution of social and behavioral change communication as an intervention to maternal knowledge in obstetric danger signs after adjusting for confounding factors such as antenatal and post-natal care attendance. Therefore, provision of information, education and communication targeting women on danger signs of pregnancy and childbirth and associated factors would be an important step towards attaining universal health coverage.
了解孕产妇对产科及新生儿并发症危险信号的认知是实现全民健康覆盖的基础。在加纳北部，孕产妇和新生儿发病率及死亡率较高，但对于这些危险信号的当前认知水平及相关决定因素却知之甚少。本研究评估了社会行为改变沟通（SBCC）方案对24个月以下儿童母亲关于产科及新生儿危险信号知识的影响。
本研究采用非随机对照社区干预设计，在加纳东部曼普鲁西区的干预社区和对照社区进行干预前后的家庭调查。研究人群采用两阶段整群抽样程序选取。
研究参与者中，分别只有521人（51.1%）、300人（29.4%）和353人（34.6%）在孕期、分娩期和产后至少知晓三种关键危险信号。该干预对孕产妇对危险信号的认知有积极影响。与对照社区的女性相比，干预社区的女性分别有高约2.6倍（调整后比值比[AOR] = 2.58 [可信区间：1.87, 3.57]）、3.4倍（AOR = 3.39 [CI：2.31, 4.96]）和2.2倍（AOR = 2.19 [CI：1.68, 2.84]）的可能性对分娩、产后及新生儿危险信号有更高的认知。至少寻求过一次产后服务与提及至少三种产后（AOR = 3.90 [CI：2.01, 7.58]）和分娩（AOR = 1.75 [CI：1.06, 2.85]）危险信号显著相关。
在调整诸如产前和产后护理就诊等混杂因素后，社会和行为改变沟通作为一种干预措施，对孕产妇关于产科危险信号的知识有显著贡献。因此，针对女性提供关于妊娠和分娩危险信号及相关因素的信息、教育和沟通，将是迈向实现全民健康覆盖的重要一步。
