Background There are several barriers that may hamper adolescent mothers’ utilization of available health interventions for perinatal depression. Innovative treatment approaches are needed to increase adolescent mothers’ access to mental health care for improved maternal and child health outcomes. Mobile phones have the potential to serve as important conduits to mental health care in Africa. However, mobile phone use patterns and needs among young mothers in Nigeria are not well documented. Objective This study sought to determine the prevalence of mobile phone use among perinatal adolescents and report patterns of use, as well as to assess the openness of young mothers to mobile health (mHealth) mental health interventions. Methods We surveyed 260 adolescent mothers (ages 16-19 years) in their perinatal or postnatal periods of pregnancies in 33 primary health care clinics in Ibadan, Oyo State, Nigeria in 2020. Respondents were included if they were pregnant with a gestation age of greater than or equal to 4 weeks, or had babies (which they had birthed) that were younger than 12 months. Results The total study sample consisted of 260 adolescent mothers with a mean age of 18.4 (SD 0.88) years. The majority of the respondents (233/260, 89.6%) owned mobile phones (eg, keypad, keypad and internet, smartphones); 22 (8.5%) of the 260 mothers had access to phones that belonged to relatives who lived in the same household, while 5 (1.9%) had access only to public paid phones. Only 23% (54/233) of phone owners (which is 20.5% of the total study population) had smartphones. On average, respondents reported first using mobile phones at 15.5 (SD 2.06) years old. The majority of respondents (222/260, 85.4%) reported using their phones for an average of 45 minutes daily for calls to family members. Facebook was the social media platform that was most often used among respondents who had phones with internet access (122/146 minutes per day, 83.4%). The majority of the sample responded as being “interested” and “very interested” in the use of mobile phones for preventive interventions (250/260, 96.2%) and treatment (243/260, 93.5%) information on mental illness such as depression and “hearing voices.” Half of the respondents (126/233, 50.4%) preferred to receive such information in the form of text messages. Conclusions Findings from this study suggest that the vast majority of perinatal adolescents in Nigeria own and use mobile phones and that they are interested in leveraging these devices for prevention, treatment, and informational campaigns focused on mental health. The use of smartphones in this population is relatively low, and health intervention through text messages were favored by the women.
Background This study describes the content validation process of the already developed English and Yoruba (poster and leaflet) and Yoruba (song) maternal depression educational materials in Nigeria. Methods This study is a cross sectional study which is a part of a larger study on training and supervision of Primary health care workers. Study utilized health professionals’ judgement for content validation, and maternal-child health clients’ evaluation for face validation with the use of Suitability Assessment of Materials (SAM). Six bilingual professionals validated both English and Yoruba version of materials (Song has only Yoruba version) and 50 clients evaluated each Yoruba material. Validity Index was calculated by formula and inter-rater agreement using intra-class coefficient (ICC) was analyzed on Professionals’ ratings. ICC, ‵t′ test and Pearson correlation were analyzed on professionals’ rating versus randomly selected six clients’ rating. Descriptive statistics, and fisher exact test were used for other statistical analysis with SPSS version 25. Results The mean age of the professionals for poster was 44.3 ± 6.0 years, for leaflet 39.8 ± 7.2 years, for song 43.8 ± 8.4 years. For maternal child health clients, mean age is: 30.7 ± 5.4 years for poster; 31.3 ± 5.2 for leaflet and 29.0 ± 5.1 for song. Outcomes of bilingual professionals’ validation are validity index: English {leaflet (0.94), poster (0.94)}, and Yoruba {leaflet (0.94) poster (0.94) and song (1.00)}. More than 80% clients rated the suitability of each material as superior. There is no significant relationship between clients’ sociodemographic characteristics and their ratings across content, literacy demand and cultural appropriateness domains of the three materials on fisher exact test. The inter-rater agreement among the professionals is excellent on leaflet and song ICC > 0.8, but it is weak on the poster ICC < 0.6. There is no inter-rater agreement on all the three Yoruba materials, but a negative linear correlation was found on the leaflet between the professionals’ ratings and the randomly selected clients’ ratings. ‵t′ test found no statistical difference in the ratings of the professionals and clients only on song material. Conclusion This study shows the process of validation of the English and Yoruba versions of the educational materials. This process should be leveraged in the content validation of other maternal-child health education materials in Africa.
Background Health workers lack the competence to address maternal depression in the routine health education in Nigeria. Hence, awareness among maternal-child health clients is low. We assessed the effect of training and supervision on knowledge, skills, and self-efficacy of primary healthcare workers in delivering health talks and the clients’ knowledge on maternal depression. Methods A quasi-experimental study design was adopted. Five Local Government Area (LGAs) in the Ibadan metropolis were grouped according to geographical proximity and randomly assigned to experimental (Group A = two LGAs) and control (Group B = three LGAs) with 12 primary health centres in each group. All primary health care workers recruited in group A received a one-day training on maternal depression. Good Knowledge Gain (GKG), Good Skill Gain (GSG) and Self-Efficacy (SEG) were assessed in both groups. 1-week post-training, the knowledge of all the PHCs’ attendees in the two groups was assessed. Two weeks post- training, a half of experimental group’s PHCs received supportive supervision and a clinic-based health education delivery skill assessment was conducted. The knowledge of clients and their health seeking were also assessed. Fisher’s exact test, independent t test and Poisson regression were used to analyze differences in percentages and mean/ factors associated with GKG, GSG and SE, using SPSS 25. Results Training improved gains in the experimental versus controls as follows: GKG (84.3% vs. 15.7%), GSG (90.7% vs 9.3%) and SEG (100% vs 0%). Training contributed to the good gain in knowledge (RR = 6.03; 95%CI =2.44–16.46; p < 0.01); skill (RR = 1.88; CI = 1.53–2.33; p < 0.01).) and self-efficacy (RR = 2.74; CI = 2.07–2.73; p < 0.01). Clients in the experimental group had higher knowledge gain score than in the control (7.10 ± 2.4 versus − 0.45 ± 2.37); p < 0.01). The rater supervisor observed better motivation in the supervised group than the not supervised. Forty clients sought help in the intervention group while none in the control group. Thirty-five clients sought help in the supervised group while only five did in the not supervised. Conclusions Training followed by supervision improved the competence of health workers to transfer knowledge to clients. This intervention is recommended for primary healthcare settings to improve uptake of maternal mental health services.
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