在多多马巴希地区，采用“M-妈妈”倡导者进行社区参与，以提高孕妇对产科危险信号的认知、分娩准备和并发症应对能力的有效性：一项整群随机实用实施试验。
The effectiveness of community engagement using M-Mama champions in improving awareness of obstetric danger signs, birth preparedness and complication readiness among pregnant women in Bahi, Dodoma: A cluster randomized pragmatic implementation trial.
作者信息
Sanga Alex, Kibusi Stephen, Kengia James Tumaini
机构信息
The University of Dodoma, School of Nursing and Public Health, Dodoma, Tanzania.
President's Office Regional Administration and Local Government, Dodoma, Tanzania.
出版信息
PLOS Glob Public Health. 2025 Apr 8;5(4):e0004315. doi: 10.1371/journal.pgph.0004315. eCollection 2025.
BACKGROUND
Maternal mortality remains a catastrophic condition for reproductive-age women in Tanzania. Inadequate ANC visits impair the efficiency of education programs for pregnant women on obstetric danger signs, birth preparedness and complication readiness, hence negatively influencing health behaviour and decision-making processes, contributing to maternal mortality. In this case, a complementary health education intervention for pregnant women in the community is necessary. M-MAMA Champions were introduced to determine their effectiveness in creating awareness of obstetric danger signs, birth preparedness complication readiness and their practice to complement the health system.
METHODS
A parallel arms, cluster-randomized pragmatic implementation trial, whereby pregnant women were recruited from four clusters and randomised at a ratio of 1:1. M-MAMA Champions empowered pregnant women with obstetric danger signs, birth preparedness and complication readiness in addition to standard care. Difference-in-difference analysis determined the intervention's effect.
RESULTS
The majority of 124 pregnant women recruited from intervention (N = 60) and control (N = 64) arms, were aged 16 to 19, 31.3% (n = 20) vs 20 to 24, 35.0% (n = 21) and had primary education 48.4% (n = 31) vs 51.7% (n = 31) in the control and intervention arms respectively. Awareness of Obstetric danger signs, birth preparedness complication readiness and their practice improved significantly by 64.2%, (P < 0.0001), 26.3%, (P = 0.00190 and 33.9%, (P = 0.0006) respectively.
CONCLUSION
M-MAMA Champions, the facilitators of women groups in community engagement are effective in improving awareness of obstetric danger signs, birth preparedness and complication readiness among pregnant women. It's, therefore worth an adoption for wider application.
TRIAL REGISTRATION
NCT06325319 (Effect of Community Engagement Using M-Mama Champions), registered on 15th March 2024.
背景
孕产妇死亡对坦桑尼亚育龄妇女来说仍然是一种灾难性状况。产前检查次数不足会削弱针对孕妇开展的关于产科危险信号、分娩准备和并发症应对准备的教育项目的效果，从而对健康行为和决策过程产生负面影响，导致孕产妇死亡。在这种情况下，有必要在社区对孕妇进行补充性健康教育干预。引入了M-MAMA倡导者来确定他们在提高对产科危险信号、分娩准备和并发症应对准备的认识以及补充卫生系统方面的有效性。
方法
一项平行组群随机实用实施试验，从四个群组中招募孕妇并按1:1的比例进行随机分组。M-MAMA倡导者除了提供标准护理外，还向孕妇传授产科危险信号、分娩准备和并发症应对准备的知识。差异分析确定了干预效果。
结果
从干预组（N = 60）和对照组（N = 64）招募的124名孕妇中，大多数年龄在16至19岁（干预组31.3%，n = 20）和20至24岁（对照组35.0%，n = 21），对照组和干预组分别有48.4%（n = 31）和51.7%（n = 31）接受过小学教育。对产科危险信号、分娩准备和并发症应对准备的认识及其实践分别显著提高了64.2%（P < 0.0001）、26.3%（P = 0.0019）和33.9%（P = 0.0006）。
结论
M-MAMA倡导者作为社区参与中妇女群体的推动者，在提高孕妇对产科危险信号、分娩准备和并发症应对准备的认识方面是有效的。因此，值得广泛采用。
试验注册
NCT06325319（使用M-MAMA倡导者进行社区参与的效果），于2024年3月15日注册。
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