Effectiveness of Trained Religious Leaders' Engagement in Maternal Health Education in Ethiopia

Effectiveness of Trained Religious Leaders' Engagement in Maternal Health Education on Improving Maternal Health Service Utilization: Cluster Randomized Controlled Trial in Hadiya Zone, Southern Ethiopia

Community education and demand generation activities by involving family members, traditional and religious leaders in maternal health behaviours are potential solutions. Knowledge about maternal and neonatal health service utilization can be increased through community-based structures, such as religious organizations.

Study Overview

• Status: Recruiting
• Conditions: Maternal Health
• Intervention / Treatment: Behavioral: Maternal health education

Detailed Description

Religious and faith community health promotions have the ability to reduce health inequities, and religious institutions are among the most respected and trustworthy institutions that can considerably boost public health work. Similarly, Faith leaders, in addition to physicians and health care providers, are another category of people who have a big impact on other people's beliefs, feelings, and behaviors, according to research. Spiritual leaders have the ability to impact health behavior on a variety of levels, from personal to ecological, with "knock-on" implications on community health. This is achieved via health education and health promoting strategies. Furthermore, the influence of faith leaders on health behavior is in line with the tenets of the Ottawa Charter for Health Promotion since they are perceived as strengthening community action. That is, communities must be empowered to participate in and govern their own affairs. A faith leader is in a unique position to encourage behavior change since he or she is a vital component of the community. According to an evaluation of programs involving faith-based organizations, clergy were able to considerably aid behaviour change, particularly among hard-to-reach populations. Other studies have also identified the importance of faith leader's influence on health behavior. Similarly, faith leaders influence on behavior has been attributed to Scripture-based passages that espouse the virtues of healthy living. Although some studies have suggested that spiritual leaders play a role in influencing congregants' health behaviors, little information on the amount of this influence and the mechanisms involved available.

In Ethiopia, the majority of the population belongs to a religious group, and religion is an important part of society. Through places of worship, religious institutions have access to a large portion of the population. Religious leaders serve as community leaders as well as gatekeepers of information and access to the population and can help raise awareness about underutilized maternal and neonatal health services. Therefore this cluster-randomized trial is designed to evaluate the effects of trained religious leaders' engagement in maternal health education in improving maternal health service utilization and knowledge of major obstetric danger signs.

• Study Type: Interventional
• Enrollment (Anticipated): 612
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Abinet A Sadore, Master; Phone Number: +251916100682; Email: abinetarege@gmail.com
• Study Contact Backup: Name: Yohannes Kebede, PhD; Phone Number: +251917025852; Email: yohanneskbd@gmail.com

Study Locations

• Ethiopia
  • Southern Nations, Nationalities, And Peoples' Region
    • Hawassa, Southern Nations, Nationalities, And Peoples' Region, Ethiopia
      • Recruiting
      • Hadiya Zone
      • Contact: Abinet A Sadore; Phone Number: 0916100682; Email: abinetarege@gmail.com
      • Principal Investigator: Abinet A Sadore, Masters
      • Sub-Investigator: Yohannes Kebede, PhD
      • Sub-Investigator: Zewdie Birhanu, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 49 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Pregnant women less than 20 weeks gestational age
• Living in selected kebele (small administrative unit in Ethiopia)
• Pregnant women willing to participate in the study

Exclusion Criteria:

• Pregnant women who are seriously ill and unable to communicate will be excluded from the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: HEALTH_SERVICES_RESEARCH
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Maternal health education; participants in the intervention group will receive behavioral change communication on maternal health from trained religious leaders. The local religious leaders from each clustered kebele will be recruited based on religious educational status (educational status greater than or equal to diploma), acceptance by their followers and popularity, in collaboration with religious organization leaders, health extension workers, and kebele leaders. Then after the potential religious leaders are recruited, the two days training will be given for them. Recruited religious leaders are expected to give training on the topics (maternal health) for four sessions to promote healthy maternal behaviors for the members of their religion. After training sessions, every participant will receive a copy of the visual materials (posters) containing the key messages for promoting prenatal health behaviors.	Behavioral: Maternal health education; The local religious leaders from each clustered kebele will be recruited based on religious educational status (educational status greater than or equal to diploma), acceptance by their followers and popularity, in collaboration with religious organization leaders, health extension workers, and kebele leaders. Then after the potential religious leaders are recruited, the two days training will be given for them. Recruited religious leaders are expected to give training on the topics (maternal health) for four sessions to promote healthy maternal behaviors for the members of their religion.
NO_INTERVENTION: Usual or routine care; The control group in this study will be on the existing routine maternal service without a provision of religious leaders' training intervention. In this arm, there will be no intervention by the researchers, rather baseline and end line data will be collected.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of skilled delivery service utilization	Proportion of skilled delivery service utilization will be measured based on women who gave birth in health center and hospital by assistance of health professionals that have midwifery skills including Midwife nurse, Nurse, Health Officers and Doctors as reported by the participant.	one month
Proportion of antenatal care service utilization	Proportion of antenatal care service utilization will be measured based on "at least one ANC attendance" (Women who have attended at least one ANC check-up during their current pregnancy) and "four or more ANC attendance" (Women who attended four or more ANC visits) during their current pregnancy as reported by the participant.	one month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of knowledge of major obstetric danger signs	Women who mention at least three neonatal danger signs will be considered to have good knowledge whereas those who mentioned less than three of the danger signs will be labelled to have poor knowledge as stated by several studies.	one month
proportion of perception of pregnancy risk	It will be assessed by using self-report questionnaire consisting of 9 items designed to measure a pregnant woman's perception of her pregnancy risks. Each question has five options (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree). Higher scores will indicate higher levels of perceived risk.	one month
Proportion of birth preparedness and complication readiness	A woman will be classified as "well birth prepared" in the most recent pregnancy if she has accomplished three of the following practices: identified skilled health professional, saved money, identified transport or had delivery kit/materials. A woman who makes arrangements for birth in less than three of the four ways will be classified as "not well birth prepared".	one month

Collaborators and Investigators

• Sponsor: Jimma University
• Collaborators: Wachemo University
• Investigators: Study Director: Yohannes Kebede, PhD, Jimma University

Study record dates

Study Major Dates

• Study Start (ANTICIPATED): March 1, 2023
• Primary Completion (ANTICIPATED): July 1, 2023
• Study Completion (ANTICIPATED): July 1, 2023

Study Registration Dates

• First Submitted: January 21, 2023
• First Submitted That Met QC Criteria: January 28, 2023
• First Posted (ACTUAL): February 8, 2023

Study Record Updates

• Last Update Posted (ACTUAL): February 13, 2023
• Last Update Submitted That Met QC Criteria: February 10, 2023
• Last Verified: February 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: RP0133/12

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Baseline characteristics, outcome measure and statistical analysis
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No