Increasing awareness of danger signs in pregnancy through community- and clinic-based education in Guatemala.
OBJECTIVE
This study evaluates the effectiveness of a set of information, education, and communication (IEC) strategies designed to increase the awareness of danger signs in pregnancy, delivery, or the postpartum period among pregnant or recently pregnant women.


METHODS
Three IEC programs were implemented in 4 regions of southwestern Guatemala between April 1997 and May 1998: (1) a clinic-based program involving the training of health providers in prenatal counseling and the provision of educational media to clients; (2) a community-based strategy consisting of radio messages regarding obstetric complications; and (3) educational sessions conducted through women's groups. Three surveys were conducted. In 1997, 637 pregnant women were interviewed at clinics where the interventions had been implemented. In 1998, 163 pregnant women using a subset of the same health clinics were interviewed. In 1999, a population-based survey of 638 pregnant and postpartum women was conducted. Using logistic regression, we model awareness of danger signs as a function of sociodemographic characteristics, prenatal care utilization, and IEC interventions.


RESULTS
Among women using health clinics, the likelihood of having heard of danger signs nearly tripled between 1997 and 1998, when the clinic interventions were fully implemented. In 1999, those who had heard radio messages or participated in women's groups were, respectively, 3 times and 5 times more likely to have heard of danger signs in pregnancy.


CONCLUSIONS
Safe motherhood programs can effectively increase knowledge of danger signs through clinic- and community-based educational strategies.
Perreira
Krista M
KM
Department of Public Policy, University of North Carolina, Chapel Hill, USA.
Bailey
Patricia E
PE
de Bocaletti
Elizabeth
E
Hurtado
Elena
E
Recinos  de Villagrán
Sandra
S
Matute
Jorge
J
D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006166:Guatemala; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000458:organization & administration*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000517:prevention & control; D015397:Program Evaluation