Effectiveness And Acceptability Of Audiovisual Aids For Increasing Knowledge Of Neonatal Danger Signs Among Primiparous Women

Abstract

Background Worldwide, neonatal mortality accounts for 46% of under-five deaths. Kenya's neonatal mortality has remained relatively constant at 23 deaths per 1,000 live births. Lack of knowledge about neonatal danger signs delays care seeking increasing the risk of morbidity and mortality. Audiovisual aids have improved knowledge and care seeking in different settings. Objective To determine whether health education using audiovisual aids( educational video) and the mother and child health booklet among primiparous women increases knowledge of neonatal danger signs compared to use of the standard mother and child health booklet alone. To evaluate acceptability of audiovisual aids for health messaging on neonatal danger signs. Study Design A mixed methods cluster randomized controlled trial. Methodology The postnatal wards of Kenyatta National Hospital were randomized using the fair coin method. In both arms, baseline questionnaires assessed knowledge of neonatal danger signs. Mothers in the intervention arm received information using an 8-minute video together with information from the mother and child health booklet. Only the mother and child health booklet was used in the control arm. Post-intervention knowledge assessment interviews via phone calls were done on day 7 and day 28. Focus group discussions assessed acceptability of the video. Results At baseline, 153 mothers were enrolled (Intervention: 77, Control: 76). The two arms of the study were comparable for socio-demographics and care seeking. At week 1, the intervention arm had greater knowledge of trouble breathing (OR 2.5 95% CI 1.25-5) and red swollen eyes with drainage (OR 2.5 95% CI 1.4-5). At week 4, the intervention arm had greater knowledge of 5 of the 10 signs i.e. less energy (OR 2.5 95% CI 1.25-5), fits (OR 2.5 95% CI 1.1-5), trouble breathing (OR 3.3 95% CI 1.6-5), skin pustules (OR 2.5 95% CI 1.1-5) and red swollen eyes with drainage (OR 5 95% CI 2-10) About 85% of mothers thought the audiovisual aids were easy to follow and understand. Conclusions Audiovisual aids were associated with sustained knowledge of neonatal danger signs and were acceptable to most women as a health education tool. Recommendations Audiovisual aids should be availed at antenatal/ outpatient clinics and postnatal wards.