Effect of a Culturally Tailored Health Education Intervention Based on Social Cognitive Theory and the Theory of Planned Behavior on Postnatal Care Utilization Among Postpartum Women in Ethiopia
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 864
- 主要终点
- Postnatal care use
研究概览
简要总结
This clinical study aims to find out if a redesigned health education program-one that respects local cultural beliefs and is based on well-known behavior change theories-can help improve how well mothers care for their newborns and how often they use postnatal care services. The main hypothesis is that culturally tailored health education provided by trained midwives will lead to: 1. Increased use of postnatal care services by mothers after childbirth, and 2. Improved knowledge among mothers about how to care for their newborns.
In the study, midwives will first be trained in how to provide this culturally appropriate health education. Then, the trained midwives will deliver four health education sessions-once a month-to pregnant women during their regular antenatal (before birth) visits at health facilities.
详细描述
Rationale and Background:
Despite the critical role of postnatal care (PNC) in reducing neonatal morbidity and mortality, it remains one of the least utilized maternal health services in Ethiopia. According to national surveys, only 35% of newborns receive a PNC checkup within the first three days postpartum. Cultural beliefs such as postpartum seclusion, fears of exposure to the "evil eye", lack of awareness, and economic barriers contribute significantly to low uptake.
Midwives serve as the primary providers of perinatal care but often lack the necessary tools, training, and culturally sensitive materials to communicate effectively. Existing counseling practices are generic, inadequately address local beliefs, and often fail to promote sustained behavior change. Thus, this study seeks to address these gaps.
The current study is a cluster-randomized controlled trial designed to evaluate the effectiveness of a culturally tailored health education intervention in improving postnatal care (PNC) utilization and maternal knowledge of newborn care among postpartum women in the Jimma Zone of Ethiopia. The intervention is grounded in two well-established behavior change models: Social Cognitive Theory and the Theory of Planned Behavior, and will be adapted to the local context through formative research, expert validation, and pilot testing.
The study targets two primary objectives:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
入排标准
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Cluster-Level Eligibility Criteria:
- •To be eligible for inclusion, clusters must meet the following criteria:
- •A catchment population size of at least 5,000 people
- •An average of more than 50 antenatal care (ANC) visits per month
- •Location in a peri-urban area to facilitate participant follow-up
- •Individual-Level Eligibility Criteria (for mothers):
- •Gestational age between 20 and 24 weeks at the time of enrollment
- •Residence within one hour's travel distance from the selected health facility
- •Individual-Level
排除标准
- •Mothers who plan to relocate from the selected cluster area before or shortly after delivery
- •Mothers who do not speak either Afan Oromo or Amharic, as these are the languages used for delivering the intervention.
- •Mothers who have already completed all recommended postnatal care visits during their most recent previous birth
结局指标
主要结局
Postnatal care use
时间窗: From birth to the end of postnatal period(6th week)
PNC utilization will be assessed based on the World Health Organization (WHO) recommendations, which define adequate postnatal care as having four scheduled contacts: within 24 hours of birth, on Day 3 (48-72 hours), between Days 7-14, and at six weeks postpartum. Data will be collected using a structured maternal postnatal care follow-up questionnaire administered during endline interviews. This questionnaire includes items capturing self-reported timing and number of PNC visits, supplemented by verification from clinic records where available. For the primary analysis, PNC utilization will be coded as a binary variable: 1 (Yes) - if the mother attended at least two postnatal care visits and 0 (No) - if the mother attended fewer than two visits. This threshold reflects a more feasible level of access in the study setting. For the secondary analysis, attendance of all four WHO-recommended visits will be assessed as an indicator of higher adherence to WHO standards.
次要结局
- Newborn care knowledge(From birth to the end of fourth week)
- Newborn care knowledge(From birth to the end of fourth week)
研究者
Firew Tiyare
Principal Investigator
Swiss Tropical & Public Health Institute