TY - JOUR
T1 - Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal
AU - Dhital, Rolina
AU - Silwal, Ram Chandra
AU - Simkhada, Padam
AU - Teijlingen, Edwin van
AU - Jimba, Masamine
PY - 2019/7/25
Y1 - 2019/7/25
N2 - INTRODUCTION: Disasters can disrupt the existing health system affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.METHODS: This is an uncontrolled before and after study conducted in Dhading district which was severely affected by the 2015 earthquake in Nepal. The study participants were mothers who had a child in the previous 12 months. The intervention was implemented between 2016 and 2018 and included community-engagement health promotion activities where the local stakeholders and resources were mobilized. The outcome variables included: knowledge of danger signs of pregnancy, childbirth and in newborns; and behaviours including ever attending antenatal care (ANC), a minimum of four ANC sessions and having an institutional delivery. Data were analysed using chi-squared tests, independent sample t-tests and multiple logistic regression models.RESULTS: In total 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001). Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries.CONCLUSION: Health promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the vulnerable population would need more support to gain benefit from such intervention.
AB - INTRODUCTION: Disasters can disrupt the existing health system affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.METHODS: This is an uncontrolled before and after study conducted in Dhading district which was severely affected by the 2015 earthquake in Nepal. The study participants were mothers who had a child in the previous 12 months. The intervention was implemented between 2016 and 2018 and included community-engagement health promotion activities where the local stakeholders and resources were mobilized. The outcome variables included: knowledge of danger signs of pregnancy, childbirth and in newborns; and behaviours including ever attending antenatal care (ANC), a minimum of four ANC sessions and having an institutional delivery. Data were analysed using chi-squared tests, independent sample t-tests and multiple logistic regression models.RESULTS: In total 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001). Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries.CONCLUSION: Health promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the vulnerable population would need more support to gain benefit from such intervention.
KW - Adult
KW - Cross-Sectional Studies
KW - Disaster Planning/standards
KW - Earthquakes
KW - Female
KW - Health Knowledge, Attitudes, Practice
KW - Health Promotion/organization & administration
KW - Humans
KW - Infant
KW - Infant Care/methods
KW - Infant, Newborn
KW - Maternal Behavior/physiology
KW - Maternal Health Services/organization & administration
KW - Mothers/psychology
KW - Nepal/epidemiology
KW - Pregnancy
KW - Pregnant Women/psychology
KW - Prenatal Care/methods
KW - Problem Behavior/psychology
KW - Surveys and Questionnaires
KW - Vulnerable Populations/psychology
KW - Young Adult
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85069975434&origin=resultslist&sort=plf-f&src=s&st1=Assessing+knowledge+and+behavioural+changes+on+maternal+and+newborn+health+among+mothers+following+post-earthquake+health+promotion+in+Nepal&st2=&sid=29863c75385ada6612d695914eba7a22&sot=b&sdt=b&sl=155&s=TITLE-ABS-KEY%28Assessing+knowledge+and+behavioural+changes+on+maternal+and+newborn+health+among+mothers+following+post-earthquake+health+promotion+in+Nepal%29&relpos=0&citeCnt=2&searchTerm=
U2 - 10.1371/journal.pone.0220191
DO - 10.1371/journal.pone.0220191
M3 - Article
C2 - 31344147
VL - 14
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 7
M1 - e0220191
ER -