Department of Health, Behaviour, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosaina, Ethiopia.
Front Public Health. 2024 Jul 29;12:1399472. doi: 10.3389/fpubh.2024.1399472. eCollection 2024.
High mortality rates for pregnant women and their new-borns are one of Africa's most intractable public health issues today, and Ethiopia is one of the countries most afflicted. Behavioral interventions are needed to increase maternal health service utilizations to improve outcomes. Hence, this trial aimed to evaluate effectiveness of trained religious leaders' engagement in maternal health education on maternal health service utilization.
The study employed a cluster-randomized controlled community trial that included baseline and end-line measurements. Data on end points were gathered from 593 pregnant mothers, comprising 292 and 301 individuals in the intervention and control groups, respectively. In the intervention group, the trained religious leaders delivered the behavioral change education on maternal health based on intervention protocol. Unlike the other group, the control group only received regular maternal health information and no additional training from religious leaders. Binary generalized estimating equation regression analysis adjusted for baseline factors were used to test effects of the intervention on maternal health service utilization.
Following the trial's implementation, the proportion of optimal antenatal care in the intervention arm increased by 21.4% from the baseline (50.90 vs. 72.3, ≤ 0.001) and the proportion of institutional delivery in the intervention group increased by 20% from the baseline (46.1% vs. 66.1%, ≤ 0.001). Pregnant mothers in the intervention group significantly showed an increase of proportion of PNC by 22.3% from baseline (26% vs. 48.3%, ≤ 0.001). A statistically significant difference was observed between in ANC4 (AOR = 2.09, 95% CI: 1.69, 2.57), institutional delivery (AOR = 2.36, 95% CI: 1.94, 2.87) and postnatal care service utilization (AOR = 2.26, 95% CI: 1.79, 2.85) between the intervention and control groups.
This research indicated that involving religious leaders who have received training in maternal health education led to positive outcomes in enhancing the utilization of maternal health services. Leveraging the influential position of these religious leaders could be an effective strategy for improving maternal health service utilization. Consequently, promoting maternal health education through religious leaders is advisable to enhance maternal health service utilization. [https://clinicaltrials.gov/], identifier [NCT05716178].
孕产妇及其新生儿死亡率高是当今非洲最棘手的公共卫生问题之一，而埃塞俄比亚是受影响最严重的国家之一。需要采取行为干预措施来增加孕产妇卫生服务的利用，以改善结局。因此，本试验旨在评估经过培训的宗教领袖参与孕产妇健康教育对孕产妇卫生服务利用的有效性。
本研究采用了一项包括基线和终点测量的集群随机对照社区试验。终点数据来自 593 名孕妇，其中干预组 292 人，对照组 301 人。在干预组中，经过培训的宗教领袖根据干预方案提供了关于孕产妇健康的行为改变教育。与对照组不同的是，对照组只接受了常规的孕产妇健康信息，没有接受宗教领袖的额外培训。采用调整基线因素的二元广义估计方程回归分析来检验干预对孕产妇卫生服务利用的效果。
试验实施后，干预组的最佳产前护理比例从基线时增加了 21.4%（50.90%比 72.3%，≤0.001），机构分娩比例从基线时增加了 20%（46.1%比 66.1%，≤0.001）。干预组孕妇的产后护理比例从基线时增加了 22.3%（26%比 48.3%，≤0.001）。干预组和对照组在 ANC4（AOR=2.09，95%CI：1.69，2.57）、机构分娩（AOR=2.36，95%CI：1.94，2.87）和产后护理服务利用（AOR=2.26，95%CI：1.79，2.85）方面存在统计学显著差异。
本研究表明，让接受过孕产妇健康教育培训的宗教领袖参与其中，可以积极促进孕产妇卫生服务的利用。利用这些宗教领袖的影响力可能是提高孕产妇卫生服务利用的有效策略。因此，通过宗教领袖促进孕产妇健康教育是提高孕产妇卫生服务利用的明智之举。[https://clinicaltrials.gov/]，标识符[NCT05716178]。
