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Effect of Safe Delivery Education on Skilled Delivery Knowledge among Pregnant Women in Nigeria

Abstract

Skilled delivery care is an essential component of maternal health and plays an important role in preventing maternal and newborn complications during childbirth. Pregnant women who understand the importance of skilled birth attendance, facility-based delivery, emergency preparedness, and timely referral may be more likely to make informed decisions about where and how to seek care during labour and delivery. However, limited knowledge, cultural beliefs, misconceptions, financial constraints, geographical barriers, previous experiences with healthcare services, and inadequate access to reliable maternal health information may influence women's decisions regarding childbirth. Safe delivery education provides an opportunity to improve pregnant women's understanding of skilled delivery, birth preparedness, recognition of complications, appropriate choice of delivery setting, and the importance of seeking assistance from qualified healthcare professionals. Against this background, this study investigates the effect of safe delivery education on skilled delivery knowledge among pregnant women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Theory of Planned Behavior. The Health Belief Model explains how pregnant women's perceptions of susceptibility to childbirth complications, perceived severity, perceived benefits of skilled delivery, perceived barriers, and cues to action may influence their knowledge and intentions regarding safe childbirth. Social Cognitive Theory emphasizes knowledge acquisition, observational learning, self-efficacy, social support, and environmental influences in the development of maternal health behaviours. The Theory of Planned Behavior explains how attitudes toward skilled delivery, subjective norms, perceived behavioural control, and behavioural intentions may influence women's understanding and future decisions regarding skilled delivery services. Collectively, these theoretical perspectives provide a suitable framework for explaining how safe delivery education may influence skilled delivery knowledge among pregnant women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise pregnant women attending selected antenatal clinics, primary healthcare centres, hospitals, maternity clinics, and community maternal health programmes across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible pregnant women. Safe delivery education will be assessed using indicators such as exposure to structured educational sessions, frequency and duration of education, information on skilled birth attendance, facility-based delivery, birth preparedness, emergency readiness, recognition of labour and maternal danger signs, appropriate referral, transportation planning, availability of birth companions, and the importance of qualified healthcare assistance during childbirth. Skilled delivery knowledge will be assessed using indicators such as knowledge of the importance of skilled birth attendants, recommended delivery settings, benefits of facility-based delivery, recognition of obstetric complications, emergency referral, birth preparedness, and appropriate actions when labour or complications occur. Data will be collected using structured questionnaires, antenatal education records, attendance registers, and relevant maternal health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to safe delivery education, and levels of skilled delivery knowledge. 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 effect of safe delivery education on skilled delivery knowledge. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention will 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 safe delivery education has a significant positive effect on skilled delivery knowledge among pregnant women in Nigeria. Pregnant women exposed to structured and evidence-based safe delivery education are expected to demonstrate greater knowledge of skilled birth attendance, facility-based delivery, birth preparedness, recognition of potential complications, and timely referral than women with limited exposure to such education. Education may correct misconceptions about childbirth, increase women's awareness of the risks associated with unskilled delivery, and strengthen their confidence in seeking appropriate maternal healthcare. It may also encourage women to discuss delivery plans with healthcare providers and families before labour begins. However, cultural beliefs, financial constraints, distance to healthcare facilities, transportation challenges, previous negative healthcare experiences, low health literacy, and limited availability of skilled maternal health services may affect women's ability to apply the knowledge gained. The study therefore expects accessible, culturally appropriate, practical, and continuous safe delivery education to contribute significantly to improved skilled delivery knowledge among pregnant women in Nigeria. The study is expected to contribute to the literature on safe delivery education, skilled delivery knowledge, skilled birth attendance, maternal health education, birth preparedness, antenatal care, facility-based delivery, maternal and newborn health, 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, primary healthcare centres, midwives, nurses, community health workers, maternal health organizations, development partners, and policymakers regarding strategies for improving maternal knowledge about safe childbirth. The study will also provide evidence-based recommendations for strengthening safe delivery education within antenatal care, improving maternal health communication, developing culturally appropriate educational materials, increasing family and community involvement in birth preparedness, strengthening referral systems, and improving access to skilled delivery services for pregnant women across Nigeria.

Keywords: Safe delivery education, skilled delivery knowledge, pregnant women, skilled birth attendance, facility-based delivery, birth preparedness, antenatal education, maternal health, maternal health education, newborn health, Nigeria, public health.