RÉSUMÉ
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 (?=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.
RÉSUMÉ
Background: Cervical cancer is a significant cause of mortality among women, particularly in developing countries. Africa has highest number of cases, with 85% occurring in developing nations. In Nairobi, low uptake of cervical cancer screening has been realized. Study explores role of CHVs in promoting screening, aiming to reduce cervical cancer incidence and mortality rates in Nairobi and similar settings. Methods: Descriptive cross-sectional study design was used. Stratified random sampling and simple random sampling methods were used. Sample size was 363 CHVs. Data collection involved collection of primary data using a self-administered questionnaire and FGDS. Data analysis was carried out through both descriptive statistics and inferential analysis. Findings were presented in percentages, pie charts. Results: Results indicated that while CHVs can play critical role in counselling women on importance of cervical-cancer screening, significant proportion of respondents had not counselled women on this topic. Similarly, while referrals are an important aspect of promoting cervical-cancer screening, majority of respondents did not refer cases of cervical-cancer screening to other CHVs. Conclusions: Study identified significant social, economic, and cultural barriers that influence cervical cancer screening participation among women. It revealed these barriers affect how CHVs promote screening. Furthermore, considerable health system obstacles hinder effective promotion of this crucial preventive measure.