Assessment Of The Impact Of Pregnacy School On Pregnancy Outcomes And Skilled Delivery In Nabdam District Of Upper East Region.

Abstract

Background: Several health interventions have been put in place to improve pregnancy outcomes all over the world including Ghana. One of such interventions was the Community Pregnancy School (C-Press) strategy, which was implemented by Catholic Relief Services (CRS) in the Nabdam district from 2014 to 2016 as part of the Rural Emergency Health Services and Transport (REST) project to improve material and child health. Objectives: This study assessed the impact of the pregnancy school strategy on pregnancy outcomes and home deliveries in the Nabdam district. Methods : A quasi-experimental study design with retrospective records review of 769 women was used out of which 398 of them benefited from the pregnancy school (intervention group) and 371 did not benefit from the pregnancy (control group). Data extraction tool was used to collect data on study participants and analysed using Stata version 15. Person’s Chi square test of association was used to determine the association between dependent and independent variables whilst t-test was used to compare the mean difference in Hb levels at 36 weeks and mean birth weight among the intervention and control groups. Also, Propensity Score Matching procedures with nearest neighbor as well other sensitivity analysis were used in determining the impact of the pregnancy school intervention on anaemia in pregnancy. Results: The study found that the impact of the pregnancy school was 34% reduced risk of anaemia at 36 weeks among the intervention group (95% CI: 21-46,p<0.001). This resulted in a mean Hb difference of 0.71g/dl between the two groups. The proportion of home delivery was also less (0.3%) in the intervention group compared to 7.5% in the control group whilst the prevalence of low birth weight was 5.2% in the intervention group compared to 17.5% in the control group [95% CI: 10.17-10.62; p-value <0.001]. The mean birth weight of those in the intervention group was 116g higher than the control group. [95% CI: 56-176; p<0.001] Conclusion: The pregnancy school had a positive impact on pregnancy outcomes and skilled delivery in the Nabdam district. There is therefore the need to scale up the project to other communities to improve maternal and child health.