Effectiveness of a Facility-Based Health Education Intervention on Utilization of Emergency Obstetric and Newborn Care Services among Women of Reproductive Age in Nakuru County, Kenya

Abstract

Purpose:Emergency obstetric and newborn care (EmONC) is the most important intervention to improve maternal survival. The study assessed facility based health education intervention on utilizationof Emergency Obstetrics and Newborn care services. MethodologyThe study was a randomized control trial and utilized a mixed method.Multistage sampling was used. Key informants were purposefully selected Allocation to each study group was done on a 1:1 ratio; hence each group had 191 participants. The sample size was determined by Kelsey et al1996 formula for calculation of sample size for randomized controlled trials and in order to take care of attrition 10% increase was done hence the sample size was 382 women. Pregnant mothers 26-32 weeks of gestation were enrolled. Structured questionnaire, focused group discussion and key informant interview schedules used. A pre-test was conducted at Kuresoi North Sub County. To ensure validity, research assistants were trained on the various research instruments. Descriptive statistics Fisher’s exact test at bivariate and odds ratio at multivariate analysis level were computed. Qualitative data was analysed using thematic content analysis. Ethical approval for the research was sought from the K.U research ethical committee, the National council for Science and Technology and Ministry of health. Informed consent was obtained from respondent prior to the study.Results: The intervention group had 95.93% (n =165) utilization of EmONC services incomparison to the control arm 75.29% (n = 128). There was no significance difference in the control group from base line to final survey OR 1.209, CI0.742 to 1.969 and P-value 0.446.From the study findings the chances of EmONC services utilization after intervention was high. Those that received the intervention were seven times likely to utilize than those that did not receive the health education with an OR 7.734, 95% CI3.363 to 17.787 and a P-value < 0.001 when we compare the intervention group and the control group. Unique Contribution to Theory, Practice and Policy:Administration ofHealth education iscrucial in the utilization of EmONC services thus improving maternal mortality and morbidity.This study concurs with the Theory of Planned Behavior and the theory of Reasoned Action. Health education intervention may change the behavior intention of the client hence influencing utilization of EmONC services. It is recommended stakeholders to come up with a well-structured health education programin all regions of Kenya to improve emergency obstetric and newborncare services utilization.