Effects of health education on spousal knowledge and participation in birth preparedness in Farafenni Regional Hospital, The Gambia: a randomized trial

BACKGROUND: The Gambia is a male-dominant society in which the cultural norms empower husbands to decide when and where their wives seek care, yet they are not always involved in maternal health care services. Therefore, the purpose of this study was to design and measure the effects of antenatal health education on spousal participation in birth preparedness in Farafenni and satellite villages. METHODS: The study used a quasi-experimental design, and the participants were 300 spouses of pregnant women attending their antenatal care booking at Farafenni Hospital. A multistage sampling method was used to select the study participants who were then equally distributed to the intervention and comparison groups. Pre-test data were collected from both groups. Thereafter, the intervention group was exposed to two health education sessions on obstetric danger signs and birth preparedness. The post-test data were collected immediately before discharge of the participants’ wives after institutional delivery or within 2 weeks post-delivery for those who did not accompany their wives to the health care institution, or whose wives delivered at home. IBM SPSS version 21 software was used to analyze the data. RESULTS: The differences between the demographic characteristics of participants in the intervention and comparison groups were not statistically significant except for the highest level of education achieved. After controlling for the demographic variables, the health education administered to the intervention group effectively increased knowledge on birth preparedness among them (F (1, 255) = 376.108, p < .001). Every unit increase in the intervention led to a unit increase in the spouses’ knowledge on birth preparedness (β = 0.789, p < 0.001). Furthermore, the participants in the intervention group had higher mean score (M = 4.4; SD = 0.8) on participation in birth preparedness than those in the comparison group (M = 0.9; SD = 0.8). The spouses in the intervention group were four times more likely to be prepared for the delivery of their wives after being exposed to the health education than those in the comparison group (F (1, 255) = 522.414, p < .001). CONCLUSION: The study provides evidence that educating men on maternal health care can improve their level of participation in birth preparedness. TRIAL REGISTRATION: Name of Registry: Pan African Clinical Trial Registry (www.pactr.org). Registry Number: PACTR202004752273171. Date of Registration: 19th April 2020. Retrospectively Registered. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-021-03605-y.