Gebretsadik Lakew Abebe, Mamo Abebe, Koricha Zewdie Birhanu, Morankar Sudhakar
Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
Eur J Public Health. 2025 Apr 1;35(2):328-334. doi: 10.1093/eurpub/ckae220.
Maternal mortality remains a critical global health challenge, with 95% of deaths occurring in low-income countries. While progress was made from 2000 to 2015, regions such as Ethiopia continue to experience high maternal mortality rates, impeding the achievement of the sustainable development goal to reduce maternal deaths to 70 per 100 000 live births by 2030. This study evaluated the effectiveness of a Social and Behavior Change Communication (SBCC) intervention to improve maternal health behaviors. A community-randomized trial was conducted in three districts of Jimma Zone, rural Ethiopia, involving 5057 women. Sixteen primary healthcare units were randomly assigned to either the intervention (SBCC) or control (standard care) group. Data on socio-demographics, antenatal care (ANC) visits, maternal health knowledge, attitudes, and institutional childbirth rates were collected at baseline and endline. Statistical analyses included t-tests, effect sizes, and generalized estimating equations. The intervention group demonstrated significant improvements. Maternal health knowledge increased from 5.68 to 7.70 (P < .001, effect size = 0.34), attitudes improved from 37.49 to 39.73 (P < .001, effect size = 0.29), and ANC visits rose from 3.27 to 4.21 (P < .001, effect size = 0.50). Institutional childbirth rates increased from 0.52 to 0.71 (P < .001, effect size = 0.18). ANC attendance (B = 0.082, P = .002) and positive attitudes (B = 0.055, P < .001) were significant predictors of institutional childbirth. The SBCC intervention significantly enhanced maternal health knowledge, attitudes, ANC utilization, and institutional childbirth rates, highlighting the value of community-based strategies in improving maternal health behaviors.
孕产妇死亡率仍然是一项严峻的全球卫生挑战，95%的死亡发生在低收入国家。尽管2000年至2015年期间取得了进展，但像埃塞俄比亚这样的地区孕产妇死亡率仍然居高不下，这阻碍了到2030年将孕产妇死亡率降至每10万例活产70例这一可持续发展目标的实现。本研究评估了社会和行为改变沟通（SBCC）干预措施对改善孕产妇健康行为的有效性。在埃塞俄比亚农村的吉马地区的三个区开展了一项社区随机试验，涉及5057名妇女。16个初级卫生保健单位被随机分配到干预组（SBCC）或对照组（标准护理）。在基线和终期收集了社会人口统计学、产前检查（ANC）就诊情况、孕产妇健康知识、态度以及机构分娩率的数据。统计分析包括t检验、效应量和广义估计方程。干预组有显著改善。孕产妇健康知识从5.68提高到7.70（P <.001，效应量=0.34），态度从37.49改善到39.73（P <.001，效应量=0.29），产前检查就诊次数从3.27增加到4.21（P <.001，效应量=0.50）。机构分娩率从0.52提高到0.71（P <.001，效应量=0.18）。产前检查就诊（B = 0.082，P =.002）和积极态度（B = 0.055，P <.001）是机构分娩的显著预测因素。SBCC干预措施显著提高了孕产妇健康知识、态度、产前检查利用率和机构分娩率，突出了基于社区的策略在改善孕产妇健康行为方面的价值。
