O2041: An Enhanced Education Package Delivered Prior to Hospital Discharge Improves Maternal Knowledge of Neonatal Jaundice After Hospital Discharge in Jinja, Uganda

Background: Neonatal jaundice remains a major contributor to neonatal morbidity and mortality worldwide. In Uganda, the neonatal mortality rate is high, at 24 per 1000 live births. Jaundice occurs primarily during the first week of life in a neonate, with the first detectable signs often occurring after the first 24 hours. In many low- and middle-income countries (LMICs), mothers and their newborn infants are often discharged during the first 24hrs after delivery. Therefore, if mothers do not have baseline knowledge about jaundice and the danger signs associated with severe jaundice, infants who develop jaundice un-noticed may go on to have the most severe outcomes. In this study, we aimed to improve maternal knowledge of neonatal jaundice through an enhanced educational package delivered prior to hospital discharge at Jinja Regional Referral Hospital (JRRH) in Jinja, Uganda.

Methods: 250 mothers were recruited from the JRRH postnatal ward. A before and after study was conducted in which a pre-intervention knowledge assessment was completed, and mothers viewed a video presentation narrated in Lusoga or English on neonatal jaundice. They also received printed information in either Lusoga or English that reviewed the information. Each mother was educated individually by trained research midwives. Follow-up knowledge assessments were conducted 7-14 days after hospital discharge from 189 mothers.

Results: Data was collected and analyzed in Stata 16. Of the 250 mothers recruited, 189 were fit for analysis. Sixty-one mothers were lost to follow-up. See Table 1 for demographics of study participants. Pre- and post- intervention knowledge assessments were compared utilizing a paired t-test. The mean pre-intervention score was 9.9. The mean follow-up knowledge score was 14.6; a difference of 4.7 points (p < 0.001) (Figure 1). Major factors associated with higher baseline knowledge included higher maternal age (p = 0.013), attendance of any antenatal care (p = 0.029) and attendance of 4 or more antenatal visits (p = 0.003).

Conclusion: In this study, we demonstrated that maternal knowledge of jaundice can be increased using a simple educational intervention delivered prior to discharge. As jaundice remains one of the leading causes of neonatal morbidity and mortality worldwide, there is a need for simple interventions like this to improve maternal knowledge of this potentially devastating condition, especially in settings where the burden of detection often falls on the mother. The factors associated with increased baseline knowledge were in line with our expectations, but it is interesting that in some cases, post-intervention knowledge scores were lower (figure 1). Further analysis is necessary to assess relevant factors to these changes. Future directions include implementation of this program at other facilities, and determining whether these types of educational interventions improve early care seeking for neonates with symptomatic jaundice.