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.

PLOS global public health Pub Date : 2025-04-08 eCollection Date: 2025-01-01 DOI:10.1371/journal.pgph.0004315
Alex Sanga, Stephen Kibusi, James Tumaini Kengia
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Abstract

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.

使用M-Mama冠军的社区参与在提高Dodoma Bahi孕妇对产科危险迹象、分娩准备和并发症准备的认识方面的有效性:一项集群随机务实实施试验。
背景:产妇死亡率仍然是坦桑尼亚育龄妇女的灾难性状况。产前检查不足影响了孕妇关于产科危险迹象、分娩准备和并发症准备的教育方案的效率,从而对健康行为和决策过程产生负面影响,导致孕产妇死亡率上升。在这种情况下,有必要对社区孕妇进行补充性健康教育干预。介绍了“产妇护理和产妇护理联盟”冠军项目,以确定其在提高对产科危险体征、分娩准备和并发症准备的认识方面的有效性,并确定其在补充卫生系统方面的做法。方法:采用平行臂、分组随机的实用实施试验,从四个分组中招募孕妇,按1:1的比例随机分组。除标准护理外,mama冠军项目还向孕妇提供产科危险信号、分娩准备和并发症准备。差异分析确定了干预的效果。结果:从干预组(N = 60)和对照组(N = 64)招募的124名孕妇中,年龄在16 ~ 19岁之间的占31.3% (N = 20), 20 ~ 24岁的占35.0% (N = 21),初等教育程度分别为48.4% (N = 31)和51.7% (N = 31)。对产科危险体征的认识、分娩准备并发症的准备及其实践分别显著提高64.2% (P < 0.0001)、26.3% (P = 0.00190)和33.9% (P = 0.0006)。结论:M-MAMA倡导者,社区参与妇女团体的促进者,在提高孕妇对产科危险迹象、分娩准备和并发症准备的认识方面是有效的。因此,它值得广泛应用。试用注册:NCT06325319(使用M-Mama Champions的社区参与效果),于2024年3月15日注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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