Full metadata record
| DC Field | Value | Language |
|---|---|---|
| dc.contributor | School of Nursing | en_US |
| dc.contributor.advisor | Ngai, Fei Wan (SN) | en_US |
| dc.contributor.advisor | Xie, Yao Jie (SN) | en_US |
| dc.creator | Gayesa, Reta Tsegaye | - |
| dc.identifier.uri | https://theses.lib.polyu.edu.hk/handle/200/14440 | - |
| dc.language | English | en_US |
| dc.publisher | Hong Kong Polytechnic University | en_US |
| dc.rights | All rights reserved | en_US |
| dc.title | The effectiveness of mobile health interventions in improving the postnatal care uptake and exclusive breastfeeding practices among first-time parents in western Ethiopia : a randomized controlled trial | en_US |
| dcterms.abstract | Background: Maternal and neonatal mortality rates in Ethiopia are considerably high and continue to challenge the health of mothers and newborns. Despite significant improvements over the last decades, the maternal mortality rate and neonatal mortality rate have remained substantial and far from reaching the sustainable development goal target. Postnatal care (PNC) is a maternal care service intended to address conditions that arise during birth to the first six weeks, during which most maternal and neonatal mortality occurs. However, PNC service utilisation is low, as only one-third of mothers in Ethiopia utilise it. Furthermore, knowledge of obstetric danger signs (ODSs) amongst women and their level of exclusive breastfeeding (EBF) is insufficient, contributing to further challenges. The literature shows that factors related to a lack of knowledge, inadequate social support, difficulties in accessing healthcare counselling and disparities in access to healthcare facilities have contributed to the poor utilisation of PNC services and related outcomes. Whilst previous studies have attempted to assess the effects of mobile health (mHealth) interventions to improve PNC uptake and EBF practices in low-income settings, the findings have been inconsistent and cannot be generalised. Moreover, mHealth interventions addressing mother–father dyads have been unexplored, and most studies lack theoretical guidance. | en_US |
| dcterms.abstract | Aim: This research project aimed to develop mobile phone-based educational message interventions for first-time parents and assess their effectiveness in enhancing PNC service utilisation, knowledge of ODSs, EBF practices, breastfeeding self-efficacy (BSE) and perceived breastfeeding support in western Ethiopia. | en_US |
| dcterms.abstract | Methods: This thesis consists of three phases. The first phase involves developing an mHealth intervention on the basis of the theory of the health belief model and social cognitive theory and the results of a systematic review and meta-analysis of the literature on the effects of mHealth interventions in enhancing childbirth in health facilities and PNC service utilisation in low-income settings. Validation of the intervention was then conducted. The second phase involves conducting psychometric testing on three outcome measurement scales in the target language. In the third phase, a two-arm parallel randomised controlled trial was conducted to assess the effectiveness of mobile-based educational interventions for 236 first-time parents in four public hospitals in western Ethiopia. The intervention group received an educational mobile message intervention delivered over 12 weeks (two times a week), starting from the gestational age (GA) of 31 weeks to six weeks after childbirth, in addition to routine care. The control group received only routine care. Assessments were taken at baseline (T0) (during pregnancy between 24 weeks of GA and 30 weeks of GA), at 6 weeks after birth (T1), at 12 weeks after birth (T2) and at 6 months after birth (T3), as applicable. | en_US |
| dcterms.abstract | The primary outcome of this study was PNC uptake, which the World Health Organisation recommends utilising four PNC services: at birth, at 48–72 hours, at 7–14 days and at 6 weeks. The secondary outcomes include knowledge of ODSs, EBF practices, BSE, breastfeeding support behaviour, maternal and neonatal mortality incidence and satisfaction with the intervention programme. The effectiveness of the intervention was assessed using generalised estimating equations and binary logistic regression on the basis of the nature of the outcomes. | en_US |
| dcterms.abstract | Results: The results of the randomised controlled trial revealed that mHealth messages effectively improved the uptake of PNC services utilised at 7–14 days postpartum (odds ratio [OR]: 2.72, 95% CI: 1.09–4.34, p = 0.027), EBF practices at T2 (OR = 1.90, 95% CI: 1.04–3.47, p = 0.036) and significantly improved mothers’ overall knowledge of ODSs over time (OR = 2.67, 95% CI: 1.14–6.23, p = 0.023), BSE at T1 (MD = 2.14, d = 0.52, p < 0.001) and T2 (MD = 1.98, d = 0.35, p = 0.016) and mothers’ perceived receipt of breastfeeding support from fathers at T2 (MD = 1.48, d = 0.40, p = 0.006), fathers' perceived provision of breastfeeding support to mothers at T1 (MD = 3.68, d = 0.35, p = 0.014) and T2 (MD = 3.33, d = 0.33, p = 0.022), all ranging from small to medium effect sizes. Despite improved outcomes amongst the intervention group, no significant differences were observed for PNC 1 (p = 0.670), PNC 2 (p = 0.117) or PNC 4 (p = 0.106). Similarly, the effectiveness of mHealth education failed to reach a significant level for the EBF rate at 6 weeks (p = 0.314) and 6 months (p = 0.096) and mothers' perceived receipt of breastfeeding support from fathers at T1 (MD = 0.98, p = 0.058). Mortality complications were also not significantly different between the intervention and control groups for mothers and newborns over the study period (X² = 0.29; p = 0.590). | en_US |
| dcterms.abstract | Conclusion: The mobile-based educational intervention significantly improved primary and secondary outcomes with small to medium effect sizes, notably enhancing the third PNC visit, knowledge of ODSs, EBF practices at three months, BSE over time and parents' perceived breastfeeding support behaviours. Therefore, the findings of this study provide empirical evidence that mHealth interventions can improve PNC service utilisation, EBF practices and related outcomes for first-time parents. In addition, the findings can enhance the ongoing efforts to improve the health of mothers and children in low-income settings. | en_US |
| dcterms.extent | xxvi, 287 pages : color illustrations | en_US |
| dcterms.isPartOf | PolyU Electronic Theses | en_US |
| dcterms.issued | 2026 | en_US |
| dcterms.educationalLevel | Ph.D. | en_US |
| dcterms.educationalLevel | All Doctorate | en_US |
| dcterms.accessRights | open access | en_US |
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