Effectiveness of Nurse-Led Behavior Change Intervention in Addressing First Maternal Delay in Nakuru County, Kenya

Context: Globally, about 700 mothers die daily during pregnancy, labor, and childbirth, a steadily increasing trend, where 40% of the cases have been linked to the first maternal delay. Pregnant mothers who experience first delay are at risk of facing several health problems, accelerating other forms of maternal delays. Aim: The study aimed to evaluate the effectiveness of a nurse-led behavior change intervention in addressing first maternal delay in Nakuru County, Kenya. Methods: The study employed a pre- and post-quasi-experimental design, utilizing a standard, structured questionnaire as a data collection tool for both the intervention and control groups. A total of 211 antenatal mothers were included in the study during pre-posttest, where 105 consented pregnant mothers at 28-30 gestational weeks, from 4 level 3 health center facilities received intervention (nurse-led behavior change intervention plus standard routine antenatal care (ANC)), while the remaining 106 consented pregnant mothers represented control group in the other 4 level 3 health facilities, they continued with their standard routine antenatal care only. The two arms of the study were studied for a period of 3 months. Results: The proportion of first maternal delay experienced among the intervention group during the baseline assessment was 78.1%, while the control group had 86.8%. However, after the study period utilizing nurse-led health education, those participants in the intervention group, experienced drastic reduction in first maternal delay experience to 0.95% (AOR, 0.004 and a p value <0.001), showing the transformative change. Conclusion: The nurse-led behavior change intervention significantly reduced the first maternal delay experience among study participants in the intervention group compared to the controls, specifically targeting the time taken to decide to seek care in an emergency during antenatal or childbirth, resulting in improvements in maternal and neonatal health. The study recommended that health authorities in both national and county governments integrate nurse-led behavior change interventions into the standard antenatal care practice for all pregnant mothers to aid in improving maternal outcomes.