The purpose of this study is to evaluate a text message intervention called Essential Coaching for Every Mother in Tanzania to improve mothers' access to essential newborn care information during the immediate six-week postnatal period.
This is a 2-group parallel arm randomized controlled trial. Participants will be randomized into either the intervention or a control group. No changes to in-person care will occur. This study will be conducted in Dar es Salaam, Tanzania with mothers recruited from a Tanzanian postnatal ward who have recently given birth at four different hospitals. Participants in the intervention group will start receiving the Essential Coaching for Every Mother program based on their delivery date up to six weeks postpartum. Mothers in the control group will not receive any text messages. Both groups will be asked to complete a survey at enrolment and six-weeks postpartum. The investigators aim to recruitment 124 participants in total, 62 per group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
124
Daily text messages for the first six-weeks postpartum.
Muhimbili University of Health and Allied Sciences
Dar es Salaam, Tanzania
Newborn Care Knowledge
Knowledge will be assessed using a modified questionnaire developed by McConnell and colleagues. Questions will determine whether mothers can identify danger signs, hand washing practices, cord care, newborn thermal care, and breastfeeding. A summative score will be created with a maximum of five points and a minimum of zero, where each point represents knowledge on the above postnatal health topics.
Time frame: Baseline (enrolment), and six-weeks postpartum (follow-up)
Maternal Self-Efficacy
Parenting self-efficacy will be measured using the Karitane Parenting Confidence Scale (KPCS) tool. This 15-item tool was developed to assess perceived self-efficacy of mothers of newborns birth to twelve months of age. A cut off score of 39 or less (out of a possible 45) was determine to be a clinically low perceived parenting self-efficacy (PPSE).
Time frame: Baseline (enrolment), and six-weeks postpartum (follow-up)
Breastfeeding Self-Efficacy
Breastfeeding self-efficacy will be measured using the Breastfeeding Self-Efficacy Scale - Short Form. Higher scores indicate higher breastfeeding self-efficacy.
Time frame: Baseline (enrolment), and six-weeks postpartum (follow-up)
Postpartum Depression
Depression will be measured using the Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a self-report screening scale with 10 items that can indicate if a respondent has symptoms related to perinatal depression with a score \>12 considered high symptoms of depression.
Time frame: Baseline (enrolment), and six-weeks postpartum (follow-up)
Postpartum Anxiety
Anxiety will be measured using the Generalized Anxiety Disorder (GAD)-7, which is a 7-item scale used to assess generalized anxiety disorder. The scale ranges between 0 and 21, with scores of 10 or greater indicative of generalized anxiety at a moderate/severe level.
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Time frame: Baseline (enrolment), and six-weeks postpartum (follow-up)
Newborn morbidity
Data will be collected on number of morbidities (e.g., diarrhea, jaundice, infection) identified per infant enrolled in the study within the 6-weeks.
Time frame: Six-weeks postpartum (follow-up)
Newborn mortality
Data will be collected on newborn mortality (e.g., number of infant deaths during study).
Time frame: Six-weeks postpartum (follow-up)
Need for readmission
Data will be collected on number of readmission to hospital for the infant and mothers during the six weeks and related reason.
Time frame: Six-weeks postpartum (follow-up)
Postnatal Clinic Attendance
Data will be collected on the number and date of postnatal contact.
Time frame: Six-weeks postpartum (follow-up)