Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya.
Pan Afr Med J. 2024 May 16;48:14. doi: 10.11604/pamj.2024.48.14.42194. eCollection 2024.
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 low-income primiparas.
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 interviewer-administered exit questionnaire was applied after 6 weeks. Focus group discussions were 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.
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 of newborn contact and six weeks contact for the dyad. Multi-pronged approaches are appreciated.
follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.
非正规住区的产妇和新生儿结局明显较差。产后护理（PNC）是一种对高死亡率人群具有重大影响的干预措施。产后教育对于采用基于证据的产后实践（PNPs）至关重要，因此对于低收入初产妇来说，产后出院后的强化教育至关重要。本研究旨在确定产后出院后随访产后教育干预（PNE）对低收入初产妇采用推荐的 PNPs 的影响。
在内罗毕非正规住区进行了一项准实验研究，每个手臂有 118 名正常分娩后早期出院的初产妇。使用访谈者管理的问卷收集设施和人口统计学数据。研究组在接受常规 PNC 之外还接受了 6 周的干预，而对照组仅接受常规 PNC。在 6 周后应用访谈者管理的退出问卷。进行焦点小组讨论以获取定性数据，然后进行主题分析。使用 SPSS 分析定量数据，然后进行描述性统计、t 检验、卡方检验、Mann-Whitney 检验以及多元线性或逻辑回归分析。PNPs 由寻求产妇和新生儿危险迹象、自我和婴儿护理实践以及利用 PNC 接触的健康组成。
干预是采用复合 PNPs（β=0.26，p=0.00）、自我护理实践（β=0.39，p=0.00）和母亲两周 PNC 接触（OR=4.64，p=0.00，95%CI=1.9-11.2）的正预测因子。对于寻求产妇（β=-0.11，p=0.31）和新生儿危险迹象（β=-0.04，p=0.73）的预测均不显著，尽管呈负相关。对婴儿护理实践、两周新生儿接触和两周母婴接触没有影响。多管齐下的方法受到赞赏。
产后出院后随访 PNE 干预可提高低收入初产妇对 PNPs 的采用，因此是常规 PNC 的有益补充。
