Development of training module of midwives on postpartum warning signs: A mixed method approach

Abstract

Introduction: To evaluate the usefulness and feasibility of developing a training module to improve the knowledge of midwives on postpartum warning signs in primary health centres, Osun State, Nigeria.

Methods: A mixed-methods approach was utilized, involving qualitative data collection through Focus Group Discussions (FGDs) with 25 midwives and a quantitative assessment of baseline knowledge using a structured questionnaire administered to 120 midwives. Data was collected over six weeks and approved by Babcock University Hospital Ethical Committee (BURHEC) and Osun State.

Results: Qualitative data from FGDs (n=25, with participants primarily aged 30-45 years and having a mean clinical experience of 10.3 ± 4.1 years in predominantly Primary Health Centre settings) provided contextual insights into current practices. Quantitative assessment of 120 midwives revealed significant baseline knowledge gaps regarding postpartum warning signs, with a mean overall knowledge score of 58.7 ± 12.3 out of a possible 100 points. Specifically, only 45.8% of midwives correctly identified all five key postpartum warning signs. For instance, only 55% recognized persistent severe headache or blurred vision as a potential sign of pre-eclampsia/eclampsia, and 62% identified fever with chills as a sign of infection. Furthermore, awareness of recommended communication strategies for educating mothers (38%) and knowledge of correct immediate actions for specific warning signs (31%) were notably low. These findings unequivocally demonstrate a substantial knowledge deficit, confirming the critical usefulness of a targeted training intervention.

Conclusion: The demonstrated significant knowledge gaps among midwives concerning the identification, management, and communication of postpartum warning signs confirm the essential usefulness and feasibility of developing a comprehensive training module. Such a module is crucial for enhancing midwives' competency in these vital areas, thereby directly contributing to improved maternal health outcomes in primary health centres.