J Health Popul Nutr. 2025 Jul 3;44(1):232. doi: 10.1186/s41043-025-00876-5.
ABSTRACT
BACKGROUND: Uganda experiences high maternal mortality ratios, with suboptimal utilization of maternal health services like antenatal care (ANC), especially in rural areas. Community Health Workers (CHWs), known as Village Health Teams (VHTs), have shown the potential to enhance maternal and child health (MCH) outcomes in Uganda by educating pregnant women in the community. However, their training models need to be refined to boost their performance.
OBJECTIVE: We evaluated the effectiveness of a contextually tailored educational intervention delivered by VHTs on the knowledge, attitudes, and antenatal care attendance of pregnant women in Eastern Uganda.
METHODS: We performed a quasi-experimental study using a pre-post-intervention evaluation conducted over six months in Eastern Uganda. We included pregnant women in their first trimester who consented to participate and excluded those in later trimesters. We performed multistage sampling with villages randomly selected and participants enrolled by trained VHTs. The VHTs were trained using a Maternal Newborn Child Health curriculum developed by a multidisciplinary team of healthcare professionals. The VHTs delivered educational sessions to the participants during home visits throughout their pregnancy. Data was collected on pregnant women’s knowledge, attitudes, and antenatal care attendance before and after the intervention. A score of ≥ 75% was considered sufficient knowledge. The Chi-square test was used to test the difference in the proportional change in knowledge and attitude of pregnant women. A paired two-sample t-test assessed changes in ANC attendance pre- and post-intervention. A p < 0.05 was considered statistically significant.
RESULTS: 228 participants were included, with a mean age of 27 ± 5.90 years and gravidity of 2.92 ± 1.47. There was a 60.7% increase in the proportion of participants with sufficient MCH knowledge after the intervention (19.6-80.3%, p < 0.001). Attitudes toward healthy MCH behaviors also improved. The proportion agreeing that attending eight or more ANC visits is crucial increased by 10.6% (88.1-98.7%, p < 0.001). Recognition of health facilities as the best place for ANC increased by 9.7% (89.9-99.6%, p < 0.001). The average number of ANC visits significantly increased from 1.22 to 6.38 (p < 0.001).
CONCLUSION: Contextually tailored education delivered by trained VHTs significantly improved maternal health knowledge, attitudes, and ANC attendance among pregnant women in rural Uganda.
PMID:40611361 | DOI:10.1186/s41043-025-00876-5
