EFFECTS OF MATERNAL SAFETY EDUCATION ON KNOWLEDGE AND PRACTICE OF MATERNAL HEALTH CARE AMONG TRADITIONAL BIRTH ATTENDANTS IN RIVERINE AREAS OF LAGOS STATE, NIGERIA

Abstract

Traditional birth attendants (TBA) are pseudo midwives with limited skill, saddled with the responsibility to take deliveries within a particular locality. There are evidences that the patronage of TBA is on the increase, their performances are replete with high incidence of infection transmission and complications, leading to high maternal morbidity and mortality. Previous studies focused largely on TBA’s patronage, effectiveness and challenges with less emphasis on educational interventions in riverine area of Epe and Ikorodu to improve on their functionality. This study was carried out to determine the effect of maternal safety education (MSE) on traditional birth attendants functionality (knowledge and practice of maternal healthcare) in Lagos State, Nigeria. The moderating effects of educational status and years of practice were also examined. Bandura’s Social Cognitive Theory was used as the framework, while the pretest-posttest control group quasi experimental design of 2x2x2 factorial matrix was adopted. Two local government areas (Epe and Ikorodu) were randomly selected, while four riverine communities that were not easily accessible were purposively selected from each LGA’s. Fifteen TBAs who are unregistered with the TBAs association in riverine communities were purposively selected. The LGA’s were randomly assigned to MSE (60) and control (60) groups while treatment lasted nine weeks. Instruments used were instructional guides, knowledge of maternal health (r=0.77), maternal health practice (r=0.95) scales. Data were analysed using descriptive statistics and Analysis of Covariance at 0.05 level of significance. Participants were females (71.7%) with mean age of 41.4 ± 3.1. There were significant main effects of treatment on knowledge (F(1,107) = 1189.16, partial ƞ2 = .42) and practice (F(1,107) = 1059.62, partial ƞ2 = .41). Safety education enhanced participants’ knowledge (48.75) and practice (48.75) of maternal healthcare posttest mean scores than those in the control group (knowledge- 22.52; practice- 21.34). There was a significant main effect of years of practice on practice (F(1,107) =7.19, partial ƞ2 = .06). Participants with longer years of practice were better in knowledge and practice of maternal healthcare (39.17) than those with short years of service (32.78). There was significant interaction effect of treatment and years of working experience on knowledge (F(1,107) = 19.61, partial ƞ2 = 16). Participants with tertiary education were better in knowledge and practice of maternal health care (44.50) than those with primary education (35.96). There were no significant main effects of educational status as well as interaction effect of treatment and educational status on knowledge and practice of maternal healthcare. The three-way interaction effect of treatment, educational status and years of working experience was also not significant.

Safety education improved knowledge and practice of maternal healthcare among TBAs in the riverine area of Lagos state. Government should ensure that there is continuous retraining on safety for TBAs so as to improve their services.