Effects of Postpartum Family Planning Counselling on Contraceptives Knowledge, Attitude and Intention Among Women Attending a General Hospital in The Gambia: A Randomized Controlled Trial.

Purpose: This study aimed to evaluate the effectiveness of PPFP counselling on contraceptives knowledge, attitudes and intention among women attending a general hospital in The Gambia. Materials and Methods: A quasi-experimental design with an intervention and comparison group was used. The intervention was PPFP counselling using the GATHER approach. A sample size of 674 participants was determined by a formula for comparison between the two groups. The questionnaire was developed based on a literature review and was pre-tested on 10% of the total study sample size (68). A reliability of 0.731 was obtained. A systematic random sampling method was employed to select study participants who met the inclusion criteria. Data were collected during face-to-face interviews in local languages with a 100% response rate at baseline and 96% at post-test. Data were analysed using the SPSS version 21.00 and the statistical analysis included both descriptive and inferential methods. An ethical approval was obtained from the Research and Ethics Committee, School of Basic Medical Sciences, College of Medicine, University of Benin (CMS/REC/2017/017) and the Gambia Government/Medical Research Council Laboratories Joint Ethics Committee (R017016Av1.1). Results: Baseline respondents' socio-demographic characteristics revealed that the two groups had similar characteristics. A statistically significant difference existed on knowledge, attitude, and intention to use contraceptive methods between the intervention and comparison groups at post-intervention (p<0.05) while no significant difference was observed at baseline. Significant gains were achieved in the intervention group in terms of knowledge, attitude, and intention post-intervention. Conclusion: PPFP counselling during the postpartum period and before the discharge of women from the hospital may improve knowledge, attitude and intention to use contraceptives and, therefore, increase the likelihood of contraceptive uptake and thus prevent unwanted and closely spaced pregnancies.

Effects of health education on spousal knowledge and participation in birth preparedness in Farafenni Regional Hospital, The Gambia: a randomized trial.

BACKGROUND: The Gambia is a male-dominant society in which the cultural norms empower husbands to decide when and where their wives seek care, yet they are not always involved in maternal health care services. Therefore, the purpose of this study was to design and measure the effects of antenatal health education on spousal participation in birth preparedness in Farafenni and satellite villages. METHODS: The study used a quasi-experimental design, and the participants were 300 spouses of pregnant women attending their antenatal care booking at Farafenni Hospital. A multistage sampling method was used to select the study participants who were then equally distributed to the intervention and comparison groups. Pre-test data were collected from both groups. Thereafter, the intervention group was exposed to two health education sessions on obstetric danger signs and birth preparedness. The post-test data were collected immediately before discharge of the participants' wives after institutional delivery or within 2 weeks post-delivery for those who did not accompany their wives to the health care institution, or whose wives delivered at home. IBM SPSS version 21 software was used to analyze the data. RESULTS: The differences between the demographic characteristics of participants in the intervention and comparison groups were not statistically significant except for the highest level of education achieved. After controlling for the demographic variables, the health education administered to the intervention group effectively increased knowledge on birth preparedness among them (F (1, 255) = 376.108, p < .001). Every unit increase in the intervention led to a unit increase in the spouses' knowledge on birth preparedness (ß = 0.789, p <  0.001). Furthermore, the participants in the intervention group had higher mean score (M = 4.4; SD = 0.8) on participation in birth preparedness than those in the comparison group (M = 0.9; SD = 0.8). The spouses in the intervention group were four times more likely to be prepared for the delivery of their wives after being exposed to the health education than those in the comparison group (F (1, 255) = 522.414, p < .001). CONCLUSION: The study provides evidence that educating men on maternal health care can improve their level of participation in birth preparedness. TRIAL REGISTRATION: Name of Registry: Pan African Clinical Trial Registry ( www.pactr.org ). Registry Number: PACTR202004752273171 . Date of Registration: 19th April 2020. Retrospectively Registered.

Economic burden and catastrophic cost among people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria.

BACKGROUND: Diabetes mellitus (DM) is a life-long illness that affects the quality of life, requiring close monitoring and control. Type 2 DM is preventable and controllable but increasing cost of care could hinder access to quality care because of inability to pay leading to high morbidity, mortality and productivity losses. The people living with diabetes mellitus (PLWD) in Nigeria have high risk for high economic burden and catastrophic expenditure not only because they make frequent visits to the health facilities, report late with complications but also pay out of pocket at the point of accessing care. The aim of this study was to assess the magnitude of economic burden borne and catastrophic costs incurred by PLWD in Nigeria. METHODS: Cross-sectional descriptive survey design was used to study a sample of 308 type2 PLWD managed at a tertiary health institution, South east Nigeria using semi-structured, prevalidated questionnaire. Data collection period was 2 months. RESULTS: The major findings were economic burden of type 2 DM of N56,245 ($356). Catastrophic direct cost was 45 % at 30 % threshold (the determinant level for catastrophic spending set). All socio-economic status (SES) groups suffered catastrophic expenditure but the poorest quartile had the highest incidence. CONCLUSIONS: Economic burden of DM was high for PLWD who also suffered high catastrophic costs due to the impact of out of pocket payment. PLWD need financial protection especially for the poorest since they buy from the same market and incur same costs. Policy decision making to assist the PLWD cope with cost of care is needful in Nigeria and nations with related problems.