Effect of Culturally Tailored Health Education on Postnatal Care Use Among Postpartum Women in Ethiopia

NCT07095296 | Not Yet Recruiting

• 1 other identifier: ECTHE-Ethiopia
• Study Type: interventional
• Target: 864
• Locations: 0 countries
• Sites: N/A

Brief Summary

This clinical study aims to find out if a redesigned health education program-one that respects local cultural beliefs and is based on well-known behavior change theories-can help improve how well mothers care for their newborns and how often they use postnatal care services. The main hypothesis is that culturally tailored health education provided by trained midwives will lead to: 1. Increased use of postnatal care services by mothers after childbirth, and 2. Improved knowledge among mothers about how to care for their newborns. In the study, midwives will first be trained in how to provide this culturally appropriate health education. Then, the trained midwives will deliver four health education sessions-once a month-to pregnant women during their regular antenatal (before birth) visits at health facilities.

Conditions

Intervention

Keywords

PNC; Counseling; Health education; Newborn care; Cluster Randomized Trial

Outcome Measures

Primary Outcomes (1)

• Postnatal care use

  PNC utilization will be assessed based on the World Health Organization (WHO) recommendations, which define adequate postnatal care as having four scheduled contacts: within 24 hours of birth, on Day 3 (48-72 hours), between Days 7-14, and at six weeks postpartum. Data will be collected using a structured maternal postnatal care follow-up questionnaire administered during endline interviews. This questionnaire includes items capturing self-reported timing and number of PNC visits, supplemented by verification from clinic records where available. For the primary analysis, PNC utilization will be coded as a binary variable: 1 (Yes) - if the mother attended at least two postnatal care visits and 0 (No) - if the mother attended fewer than two visits. This threshold reflects a more feasible level of access in the study setting. For the secondary analysis, attendance of all four WHO-recommended visits will be assessed as an indicator of higher adherence to WHO standards.

  From birth to the end of postnatal period(6th week)

Secondary Outcomes (1)

• Newborn care knowledge

  From birth to the end of fourth week

Study Arms (2)

control

NO INTERVENTION

The control group will not receive the culturally tailored intervention. Instead, participants in this group will receive the standard routine antenatal care and postnatal health education currently provided at health facilities.

intervention

EXPERIMENTAL

Women in the experimental group will receive four educational sessions, each lasting approximately 15 to 20 minutes, delivered after the completion of routine ANC services. The sessions will be conducted in small groups, with one midwife assigned to every five pregnant women, and included verbal interaction, video presentations, and practical demonstrations.

Behavioral: Health Education

Interventions

Health Education BEHAVIORAL

The intervention-a culturally tailored and redesigned health education-will be guided by established behavioral theories, namely the Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT) and implemented in a culturally sensitive manner. The TPB focuses on attitudes toward utilizing PNC services, the influence of subjective norms such as cultural norm, and their perceived behavioral control including transportation (34), while SCT emphasizes self-efficacy, social modeling, and reinforcement(35). Both TPB and SCT have been extensively validated in various health behavior studies, supporting their relevance and applicability in this context(36, 37). Our intervention will consist of a structured training foe health extension worker and mentorship program. The intervention package, including the training curriculum and implementation manual, will be developed in accordance with guidelines from the World Health Organization (WHO) and the Federal Ministry

intervention

Eligibility Criteria

• Gender Eligibility Details: pregnancy
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may not qualify if:

• Mothers who plan to relocate from the selected cluster area before or shortly after delivery
• Mothers who do not speak either Afan Oromo or Amharic, as these are the languages used for delivering the intervention.
• Mothers who have already completed all recommended postnatal care visits during their most recent previous birth

Sponsors & Collaborators

• Swiss Tropical & Public Health Institute: lead

MeSH Terms

Conditions

Health Education

Condition Hierarchy (Ancestors)

Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Central Study Contacts

Firew Tiruneh Tiyare, PhD candidate

CONTACT

+251 91 783 0101; firew.tiyare@swisstph.ch

Prof. Dr. Günther Fink, Ph.D. in economics

CONTACT

guenther.fink@swisstph.ch

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This study is designed as a two-arm cluster randomized controlled trial.

Study Record Dates

• First Submitted: July 8, 2025
• First Posted: July 31, 2025
• Study Start: December 1, 2025
• Primary Completion: December 1, 2025
• Study Completion (Estimated): July 1, 2026
• Last Updated: December 3, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share