Behavior Change Following Implementation of Home‐Based Life‐Saving Skills in Liberia, West Africa

Abstract

Introduction Home-Based Life Saving Skills (HBLSS) has been fully integrated into Liberia’s long term plan to decrease maternal and newborn mortality and morbidity coordinated through the Ministry of Health and Social Welfare. The objective of this article is to disseminate evaluation data from project monitoring and documentation on translation of knowledge and skills obtained through HBLSS into behavior change at the community level. Methods One year after completion of HBLSS training, complication audits were conducted with 434 postpartum women in one rural county in Liberia. Results Sixty-two percent (n=269) of the women were attended during birth by either an HBLSS-trained traditional midwife or family member, while 38 percent (n=165) were attended by a traditional midwife or family member who did not receive HBLSS training. HBLSS trained birth attendants performed significantly more First Actions (lifesaving actions taught to be performed after every delivery) than the non HBLSS trained attendants. Fourteen percent of our sample (n=62) reported “too much bleeding” following the delivery. Of these women, approximately half (n=29) were attended by an HBLSS-trained traditional midwife or family member. There was a significant difference in Secondary Actions (those actions taught to be performed when a woman experiences “too much bleeding” following childbirth) that were reported to have been performed by HBLSS-trained attendants (mean = 5.26, SD = 1.88) and untrained attendants (mean = 2.73, SD = 1.97); p-value <.0001. Conclusion Our findings suggest HBLSS knowledge is being transferred into behavior change and used at the community-level by traditional midwives and family members.

What matters to women and healthcare providers in relation to interventions for the prevention of postpartum haemorrhage: A qualitative systematic review

“…protection against evil spirits, conflict with Westernized understandings of PPH and remain a challenge in some LMICs [58, 59, 60]. Formal education programmes designed to increase awareness of the potential dangers of PPH may improve understanding in these contexts [61], although recent research conducted in rural contexts in Kenya and Malawi suggests community-led women’s groups may be more beneficial in raising awareness of maternal complications (including PPH) in these communities [62, 63].…”

Knowledge and Skills Retention Among Frontline Health Workers: Community Maternal and Newborn Health Training in Rural Ethiopia

“…Moreover, knowledge retention was also high for Prevent Problems After Baby Is Born among health extension workers in the Amhara (16 of 16 care steps) and Oromiya (14 of 16 care steps) regions. These findings complement prior work in other contexts such as Bangladesh, India, Liberia, and southern Ethiopia where the HBLSS training approach has been successful in transferring knowledge and behavior change among health workers, women, and family caregivers.…”

Senales de Peligo: Guatemalan Lay Midwives’ Perceptions of Responding to Obstetrical Complications

“…The interviews were conducted as part of a larger study to evaluate the efficacy and change of LMs' knowledge about obstetrical emergencies after training sessions measured by pre-and posttests and have been published elsewhere (Garcia, Dowling, & Mettler, 2018). The training was based on the Home Based Life Saving Skills curriculum from the American College of Nurse Midwives, which has been field-tested in low-resource countries with notable success (Dynes et al, 2011;Lori, Amable, Mertz, & Moriarty, 2012;Lori, Majszak, & Martyn, 2010). The American College of Nurse Midwives curriculum taught/ reviewed recognition and home management of obstetrical emergencies and appropriate hospital transfer.…”