Effect of post-discharge postnatal educational intervention on maternal self-efficacy among low-income primiparas living in informal settlements in Nairobi County, Kenya

Authors

  • Immaculate Wambui Kamau Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya https://orcid.org/0000-0002-6963-6256
  • Margaret Nyanchoka Keraka Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya
  • Eliphas Gitonga Department of Environmental and Occupational Health, School of Health Sciences, Kenyatta University, Nairobi, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20240602

Keywords:

Postnatal care, Informal settlement, Postnatal education, Primiparas, Low-Income, Maternal self-efficacy

Abstract

Background: Maternal knowledge and maternal self-efficacy (MSE) are crucial for the adoption of health-promoting evidence-based postnatal practices. Short hospital stay after normal deliveries curtails delivery of pre-discharge postnatal education thus inadequate knowledge and poor MSE. This is accentuated among low-income primiparas thus a need for post-discharge follow-up. Aim was to determine the effect of self-efficacy theory-based post-discharge postnatal education on low-income primiparas’ MSE.

Methods: A Quasi-experimental study on low-income primiparas residing in selected slums in Nairobi, Kenya. The control and experimental sites had 118 primiparas each conveniently recruited on early discharge after normal delivery from health facilities serving the slums. An interviewer-administered entry questionnaire was applied to collect facility and demographic data. The intervention group received post-discharge PNE intervention and routine PNC while the control group received routine PNC only. Perceived maternal parental self-efficacy scale was used to measure MSE at 6 weeks. Focus group discussions were conducted for qualitative data. IBM SPSS was used to analyze data. Independent sample t-tests and multiple linear regression were derived.

Results: There was a significant (t=12.322, p=0.000) difference in MSE between experimental and control groups. The intervention was a significant predictor of MSE (β=0.59, p=0.00). Respondents appreciated the multi-pronged learning methods, especially the community health volunteers. COVID-19 pandemic challenges such as loss of livelihood and disruption of social connectedness were highlighted.

Conclusions: Self-efficacy theory-based follow-up PNE intervention improves MSE among low-income primiparas thus a valuable complement to routine care.

Metrics

Metrics Loading ...

References

WHO Recommendations on Maternal and Newborn Care for a Positive Postnatal Experience. Available at: https://www.who.int. Accessed on 20 November 2023.

Kenya Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) Investment Framework. Available at: http://www.global financing facility.org/sites/gff_new/files/documents/ Kenya RMNCAH Investment Framework_March 2016.pdf. Accessed on 20 November 2023.

Beguy D, Elung’ata P, Mberu B. Health & Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Int J Epidemiol. 2015;44(2):462-71.

Kenya National Bureau of Statistics. Available at: https://www.knbs.or.ke. Accessed on 20 November 2023.

Subramanian L, Murthy S, Bogam P. Just-in-time postnatal education programees to improve newborn care practices: needs and opportunities in low-resource settings. BMJ Glob Health. 2020;5(7):e002660.

Osborn CY, Paasche-Orlow MK, Bailey SC, Wolf MS. The Mechanisms Linking Health Literacy to Behavior and Health Status. Am J Health Behav. 2011;35(1):118-28.

Bandura A. Self Efficacy. Encycloped Human Behav. 1994;4:71-81.

Zheng X, Morrell J, Watts K. A quantitative longitudinal study to explore factors which influence maternal self-efficacy among Chinese primiparous women during the initial postpartum period. Midwifery. 2018;59:39-46.

Lee JY, Murray N, Ko J, Kim T. Exploring the Relationship between Maternal Health Literacy, Parenting Self-Efficacy, and Early Parenting Practices among Low-Income Mothers with Infants. J Health Care Poor Underserved. 2018;29(4):1455-71.

Botha E, Helminen M, Kaunonen M, Lubbe W, Joronen K. Mothers’ parenting self-efficacy, satisfaction and perceptions of their infants during the first days postpartum. Midwifery. 2020;88:1-6.

Copeland DB, Harbaugh BL. Early Maternal-Efficacy and Competence in First-Time, Low-Income Mothers. Compr Child Adolesc Nurs. 2017;40(1):6-28.

Shorey S, Wai S, Chan C, Chong YS, He H. A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on self-efficacy, social support and postnatal depression among primiparas. J Adv Nurs. 2015;71(6):1260-73.

Fathi F, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Maternal self-efficacy, postpartum depression, and their relationship with functional status in Iranian mothers. Women Health. 2018.

Abuhammad S. Predictors of maternal parenting self-efficacy for infants and toddlers: A Jordanian study. PLoS One. 2020;15(11):241.

Samdan G, Reinelt T, Kiel N, Mathes B, Pauen S. Maternal self-efficacy development from pregnancy to 3 months after birth. Infant Ment Health J. 2022;43(6):864-77.

Azmoude E, Jafarnejade F, Mazlom SR. The Predictors for Maternal Self-efficacy in Early Parenthood. J Midwifery Reprod Health. 2015;3(2):368-76.

Khadijeh H, Shakibazadeh E, Mehrizi SS, Sadeghi R. The role of perceived barrier in the postpartum women’s health promoting lifestyle: A partial mediator between self-efficacy and health promoting lifestyle. J Educ Health Promot. 2018;7(38):1-11.

Wang Q, Zhang Y, Li X. Exploring maternal self-efficacy of first-time mothers among rural-to-urban floating women: A quantitative longitudinal study in china. Int J Environ Res Public Health. 2021;18(6):1-12.

Dol J, Richardson B, Grant A. Influence of parity and infant age on maternal self-efficacy, social support, postpartum anxiety, and postpartum depression in the first six months in the Maritime Provinces, Canada. Birth. 2021;48(3):24-9.

Nan Y, Zhang J, Nisar A. Professional support during the postpartum period: Primiparous mothers’ views on professional services and their expectations, and barriers to utilizing professional help. BMC Preg Childbirth. 2020;20(1):1-13.

Liyana Amin NA, Tam WWS, Shorey S. Enhancing first-time parents’ self-efficacy: A systematic review and meta-analysis of universal parent education interventions’ efficacy. Int J Nurs Stud. 2018;82:149-62.

Bagherinia M, Meedya S, Mirghafourvand M. Association between maternal sense of competence and self-efficacy in primiparous women during postpartum period. Shiraz E Med J. 2018;19(3):12-8.

Smith H, Harvey C, Portela A. Discharge preparation and readiness after birth: a scoping review of global policies, guidelines and literature. BMC Preg Childbirth. 2022;22(1):1-19.

Finlayson K, Crossland N, Bonet M, Downe S. What matters to women in the postnatal period: A meta-synthesis of qualitative studies. PLoS One. 2020;15(4):1-23.

Dol J, Campbell-Yeo M, Tomblin Murphy G. Parent-targeted postnatal educational interventions in low and middle-income countries: A scoping review and critical analysis. Int J Nurs Stud. 2019;94:60-73.

Gandomi N, Sharifzadeh G, Torshizi M, Norozi E. The effect of educational intervention based on self-efficacy theory on pregnancy anxiety and childbirth outcomes among Iranian primiparous women. J Educ Health Promot. 2022;11(1):14.

Shorey S, Ng YPM, Ng ED. Effectiveness of a technology-based supportive educational parenting program on parental outcomes (Part 1): Randomized controlled trial. J Med Internet Res. 2019;21(2):1-26.

Chegini LZ, Kamrani MA, Shiri M, Farid M, Homami S. The effect of an empowerment training program on the difficulty of the transition to parenthood and parenting stress: A quasi-experimental study among iranian primiparous women. Shiraz E Med J. 2021; 22(3):1-8.

McKee CL, Stapleton P, Pidgeon AM. Delphi Expert Parent Study: Factors Needed for 21st Century Pre- and Perinatal Parenting Programs. J Perinat Educ. 2019;28(3):163-79.

Atahigwa C, Kadengye DT, Iddi S, Abrams S, Van Rie A. Trends and determinants of health facility childbirth service utilization among mothers in urban slums of Nairobi, Kenya. Glob Epidemiol. 2020;2:100029.

Chan Y. Randomised controlled trials (RCTs)-sample size: the magic number? Singapore Med J. 2003;172(4):172-4.

Mugenda O, Mugenda A. Research Methods: Quantitative and Qualitative Approaches. Acts Press. 1999.

WHO Recommendations on Postnatal Care of the Mother and Newborn. Available at: https://www. who.int/maternal_child_adolescent/documents/postnatal-care-recommendations/en/. Accessed on 20 November 2023.

Bringing Care To Life: Clear, practical and trusted videos with step-by-step guidance for health workers and caregivers in multiple languages. Available at: https://globalhealthmedia.org/. Accessed on 20 November 2023.

Shorey S, Chan W chi S, Chong YS, He H. Protocol: A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on outcomes of primiparas: study protocol. J Adv Nurs. 2014;71(1):193-203.

Koochakzai M, Mansouri A, Safarzadeh A, Navidian A. Effects of postnatal home-based education on primiparous women’s perceived self-efficacy in neonatal care. J Clin Diagnos Res. 2018;12(7):QC01-4.

Yonemoto N, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Cochrane Database Syst Rev. 2021;2021(7):23-9.

Buchanan S, Jardine C. The complex information needs of disadvantaged young first-time mothers: insights into multiplicity of needs. J Documentation. 2020.

Xiao X, Ngai F wan, Zhu S ning, Loke AY. The experiences of early postpartum Shenzhen mothers and their need for home visit services: a qualitative exploratory study. J Clin Diagnos Res. 2020;8:1-12.

Lin HC, Zehnah PL, Koire A, Mittal L, Erdei C, Liu CH. Maternal Self-Efficacy Buffers the Effects of COVID-19–Related Experiences on Postpartum Parenting Stress. JOGNN - J Obstet Gynecol Neonat Nurs. 2022.

Downloads

Published

2024-02-29

How to Cite

Kamau, I. W., Keraka, M. N., & Gitonga, E. (2024). Effect of post-discharge postnatal educational intervention on maternal self-efficacy among low-income primiparas living in informal settlements in Nairobi County, Kenya. International Journal Of Community Medicine And Public Health, 11(3), 1049–1057. https://doi.org/10.18203/2394-6040.ijcmph20240602

Issue

Section

Original Research Articles