Knowledge of Public Health Midwives in the Kalutara District in Relation to Domiciliary Postnatal Care

Abstract

Introduction In Sri Lanka Public Health Midwives (PHMM) have the key responsibility in the provision of domiciliary postnatal care (DPNC) at the implementation level. Her performance has a great influence on health of the postpartum mother and her newborn. The PHMM should therefore be competent in their knowledge to deliver quality DPNC. Objective To develop and validate an instrument to assess knowledge of the PHMM on DPNC and to assess knowledge of PHMM on DPNC in the Kalutara district Methodology The study had two phases: 1.Development and validation of an instrument (10 multiple choice and 05 short answer structured questions) to assess knowledge of PHMM on DPNC. This was done through task analysis and expert opinion. 2. Assessment of knowledge on DPNC among PHMM in the Kalutara district. A community based descriptive cross sectional study was carried out among a sample of 272 PHMM. The instrument developed was valid and reliable for the assessment of knowledge of the PHMM. PHMM’s knowledge on DPNC was not satisfactory with a mean total score of 53.2 (SD±10.09). Lowest mean scores were obtained for ‘Normal/abnormal conditions of the newborn’ (1.89 ± 1.38), “postpartum family planning’ (1.43 ± 1.01) and “Postpartum exercises’ (3.68 ± 2.50). Knowledge score was statistically significantly higher among PHMM with G.C.E. O/L or above educational level and in those with very good or good level of satisfaction on DPNC (p<0.001). A statistically significant (p<0.001) stepwise decrease in total knowledge score was observed from lower to higher age groups. Service experience and the grade of the PHMM showed negatively significant association (p<0.001) with knowledge. Conclusions and/or Recommendations The instrument can be used to assess the knowledge of PHMM in Sri Lanka. Knowledge of the PHMM was poor in relation to postpartum exercises, postpartum family planning and neonatal care. Capacity building of PHMM is recommended in relation to DPNC through in-service training.