EFFECT OF TRAINING ON HEALTH WORKERS’ KNOWLEDGE OF THE NUTRITION COMPONENTS OF SAFE MOTHERHOOD INITIATIVE IN EGBEDA LOCAL GOVERNMENT AREA, OYO STATE, NIGERIA.

Abstract

Safe Motherhood Initiative (SMI) was launched with the aim of reducing the high maternal mortality ratio in developing countries and health workers are key to achieving this. One of the core components of SMI is nutrition, yet most studies in Nigeria have not addressed this nutrition component adequately. This study was therefore designed to determine the effect of training on knowledge of health workers on the nutrition component of SMI in Egbeda Local Government Area (LGA), Oyo State. The study was quasi-experimental involving 30 female health workers each purposively selected from the 21 Primary Health Centers (PHC) in Egbeda LGA (experimental group) and 20 PHC in Ido LGA (control group). The two groups completed a validated semi-structured questionnaire at baseline to obtain data on socio-demographic characteristics, knowledge of nutrition information for pregnant women, specific micronutrients required during pregnancy and their food sources, and perception towards components of safe motherhood using knowledge and perception scales of 42-point and 28 points respectively. The knowledge score was categorized as poor (0-20) and good (21-42) while the perception score was classified as poor (0-13) and good (14-28). The knowledge gaps identified from the baseline survey was used to design one-day training for the experimental group based on the Academy for Educational Development Standard. A post-intervention survey was conducted immediately and one month after the training among the two groups using the questionnaire used at baseline. Data were analyzed using descriptive statistics, student t-test and logistic regression. The mean ages of the experimental and control groups were 46.0±4.0 and 47.6±5.5 years, respectively. Among the experimental group, 80.0% were Community Health Workers (CHW) and 20.0% were nurses. Majority (93.3%) of the control group were CHW. All participants in both groups had tertiary education. At baseline 50% and 36.7% of the experimental and control groups correctly stated folic acid, iodine, vitamins A and B12 as the micronutrients required during pregnancy while 90.0% and 36.9%, respectively stated it at post-intervention. Mean knowledge scores at baseline, immediate post-intervention and one month post-intervention were 12.6±2.9, 36.9±3.6 and 39.9±1.7, respectively in the experimental group (p<0.05) and 12.2±2.8, 13.7±2.8 and 13.6±2.5, respectively in the control group. The changes in mean knowledge scores vi between the experimental and control groups at the different time of assessment were significant. All participants in both groups perceived pre-conception, antenatal and postnatal cares as components of safe motherhood initiative at baseline and post-intervention. The mean perception scores at baseline, intervention and one month post-intervention for experimental group were 20.2±4.8, 21.1±2.3 and 23.0±3.4, respectively compared with 19.2±3.8, 20.3±3.6 and 22.4±4.3 in control, respectively. Having more years of service was significantly associated with good knowledge score post-intervention (OR=4.6, CI=2.5-8.4). The training improved health workers’ knowledge on nutrition components of safe motherhood initiative especially among those with good perception of the initiative. There is need for continuing training of health workers’ on nutrition component of safe motherhood initiative.