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Impact of Caesarean Section Wound-Care Education on Wound-Care Practices among Post-Caesarean Women in Nigeria

Abstract

Caesarean section is an important obstetric intervention used when vaginal delivery may pose risks to the mother or baby. Although caesarean delivery can be lifesaving, post-caesarean women may experience wound-related complications such as surgical-site infection, wound separation, delayed healing, pain, redness, swelling, and abnormal wound discharge. Appropriate wound-care practices after discharge are essential for promoting healing and reducing preventable complications. However, inadequate knowledge, misconceptions, poor access to follow-up services, financial constraints, limited postnatal support, and uncertainty about wound cleaning, dressing, activity restrictions, and warning signs may negatively affect women's wound-care practices. Caesarean section wound-care education provides an opportunity to equip women with practical information and skills needed to care for their surgical wounds and recognize complications requiring professional attention. Against this background, this study investigates the impact of caesarean section wound-care education on wound-care practices among post-caesarean women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Self-Efficacy Theory. The Health Belief Model explains how women's perceptions of their susceptibility to wound complications, perceived severity, perceived benefits of appropriate wound care, perceived barriers, and cues to action may influence their wound-care practices. Social Cognitive Theory emphasizes observational learning, behavioural reinforcement, environmental influences, and interaction between knowledge and behaviour in the adoption of appropriate wound-care practices. Self-Efficacy Theory emphasizes women's confidence in their ability to perform wound care correctly, follow healthcare instructions, recognize warning signs, and seek appropriate medical attention. Collectively, these theoretical perspectives provide a suitable framework for explaining how caesarean wound-care education may influence wound-care practices among post-caesarean women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women who have undergone caesarean section and are receiving postnatal care or have been discharged from selected hospitals, maternity facilities, primary healthcare centres, and postnatal clinics across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible post-caesarean women. Caesarean wound-care education will be assessed using indicators such as exposure to structured education, timing and frequency of education, wound-cleaning instructions, dressing and hygiene guidance, handwashing, activity and lifting advice, medication adherence, nutrition and hydration advice, recognition of wound warning signs, instructions on when to return to the healthcare facility, follow-up appointments, and opportunities for women to practice or clarify wound-care procedures. Wound-care practices will be assessed using indicators such as hand hygiene before wound care, appropriate wound cleaning, dressing practices, keeping the wound clean and dry as advised, adherence to prescribed medications, avoidance of inappropriate substances or unapproved remedies, compliance with activity recommendations, attendance at follow-up appointments, monitoring for signs of infection, and timely healthcare-seeking when complications occur. Data will be collected using structured questionnaires, wound-care practice checklists, postnatal records, hospital discharge records, follow-up registers, and relevant healthcare documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to wound-care education, and patterns of wound-care practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of caesarean section wound-care education on wound-care practices. Where a quasi-experimental design is adopted, wound-care practice scores before and after the educational intervention may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that caesarean section wound-care education has a significant positive impact on wound-care practices among post-caesarean women in Nigeria. Women exposed to structured, practical, and culturally appropriate wound-care education are expected to demonstrate better adherence to recommended wound-care practices than women receiving routine discharge instructions alone. Education may improve women's ability to maintain wound hygiene, follow medication instructions, recognize early signs of infection, comply with follow-up appointments, and seek timely professional care when complications occur. Practical demonstrations and individualized counselling may further improve women's confidence in managing their wounds at home. However, maternal fatigue, pain, limited social support, financial barriers, poor access to follow-up services, cultural practices, misconceptions about wound care, and inadequate continuity of postnatal care may affect adherence. The study therefore expects accessible, practical, individualized, and continuous caesarean wound-care education to contribute significantly to improved wound-care practices and safer recovery among post-caesarean women in Nigeria. The study is expected to contribute to the literature on caesarean section wound-care education, post-caesarean wound-care practices, maternal postnatal care, surgical-site infection prevention, maternal health education, postpartum healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, maternity facilities, nurses, midwives, community health workers, maternal health organizations, development partners, and policymakers regarding strategies for improving post-caesarean care. The study will also provide evidence-based recommendations for strengthening discharge education, incorporating practical wound-care demonstrations into postnatal services, training healthcare providers in effective patient education, improving follow-up and referral systems, providing culturally appropriate wound-care materials, and strengthening community-based postnatal support for women recovering from caesarean section across Nigeria.

Keywords: Caesarean section wound-care education, wound-care practices, post-caesarean women, surgical-site infection prevention, postnatal care, maternal health education, wound healing, postpartum care, healthcare-seeking, Nigeria, public health.