THE IMPACT OF AN EDUCATIONAL INTERVENTION ON THE KNOWLEDGE OF BILATERAL TUBAL LIGATION AMONG WOMEN ATTENDING ANTENATAL AND FAMILY PLANNING CLINICS IN BOMET COUNTY: AN INTERVENTIONAL STUDY

Abstract

Bilateral Tubal Ligation (BTL) is a highly effective contraceptive method with more than 99% effectiveness at preventing pregnancy. Its uptake remains low in Sub-Saharan Africa at 1.6%. The Kenya Health and Demographics Survey (KHDS) 2014, indicated that almost half of the married women did not desire further childbearing but with low utilization of permanent contraceptive methods (BTL). This gap highly contributes to rising numbers of unintended pregnancies and subsequent rise in maternal deaths, risk of abortions, and its associated complications. The low acceptance of BTL as a method of contraception in this region has been attributed to a lack of knowledge, cultural and religious misconceptions. This study aimed to determine the level of knowledge about BTL at baseline and the impact of an educational intervention among women attending ANC/Family planning clinics at Tenwek and Longisa Hospitals in Bomet County. A quasi-experimental study design was used. Demographic characteristics, knowledge of BTL, perceived risks, and benefits were assessed at baseline and post-intervention. A difference measure was used to assess the impact of the intervention at 95% CI, with a p-value of 0.05 considered significant. The data was analysed using STATA version 18.Eighty (80) women were targeted in each of the phases. The selection was through simple random sampling. A pre-designed, pre-tested, and semi-structured questionnaire was utilized. Student's t-test was used to compare knowledge scores for participants in the pre and post-interventional phases.The mean age of the participants at baseline and post-intervention was 29.0±5.8 years and 29.2±5.6 years, respectively. Overall, 62% of participants said they would choose BTL, with 52% in the post-intervention arm.The knowledge assessment results showed that participants with postsecondary education had higher average knowledge scores (4.1 out of 6) than those without postsecondary education (3.5 out of 6), with a significant difference (p-value=0.02). For knowledge scores, forty-three per cent (43%) of women had a poor knowledge score in the pre-intervention phase and fifty-six per cent (56%) in the post-intervention phase. Fifty-four per cent (54%) of women had a moderate score in the baseline survey, and forty-five per cent (45%) followed the intervention. For the women with good knowledge scores, forty-six per cent (46%) were in the post-interventional phase with fifty-three per cent (53%) in the baseline survey. The measure of effect on educational intervention showed no significant difference between pre-and post-intervention scores.In general, lower knowledge scores were obtained in the post-intervention arm, implying that the educational intervention provided did not influence participants' knowledge of BTL. There was no statistically significant difference in the participants' knowledge levels at baseline and post-intervention [3.3 (-3.2 to 9.9); p-value=0.3].Educating families, particularly women of childbearing age, about alternative family planning methods would increase uptake, allowing families to achieve desired family sizes while limiting the impact of unwanted pregnancies and maintaining a healthy population.