Effectiveness of Community Engagement Using M-Mama Champions in Improving Literacy of Obstetric Danger Signs, Birth Preparedness and Complication Readiness among Pregnant Women in Bahi, Dodoma. A Community-Based, Cluster Randomized Controlled Trial

Abstract Background: Maternal mortality remains a global public health issue, Sustainable Development Goal 3 targets to reduce it to less than 70 for every 100,000 live births by 2030. Maternal mortality whose peak is during intrapartum and the first day post-partum, 75% of it is accounted for by obstetric danger signs complications. Tanzania’s maternal mortality ratio stands at 104 for every 100,000 live births higher than the SDG target. Innovations that include M-MAMA Champions as facilitators in women groups are necessary to improve the literacy level of obstetric danger signs, birth preparedness, and complication readiness among pregnant women and enhance obstetric emergency response and service utilization, for essential interventions in healthcare facilities alone haven’t been able to reduce maternal mortality due to poor services utilization. Methods: In a community-based, parallel-group cluster randomized controlled trial (cRCT) design, a total of 120 first and second-trimester pregnant women will be randomized at a ratio of 1:1 to the intervention and control groups. The sensitizing pregnant women on Obstetric danger signs, birth preparedness, and complication readiness by the empowered M-MAMA Champions to the intervention arm will be done for a period of one month, each two-hour session will be delivered in an interval of two weeks, using participatory learning and action model. The effect of the intervention will be determined using repeated ANOVA analysis, of which the effect of M-MAMA Champions on literacy level and practice between arms will be determined. Discussion; Implementation fidelity of the intervention will be ensured through implementation observation by the researcher, research assistants, and the community health workers. Ethics approval and consent to participate; The University of Dodoma Research Ethics Committee approved this study (Ref. No. MA.84/261/02/1/115). The study will ensure the protection of the participants’ values, dignity, and integrity per the Helsinki Declaration by the World Medical Association.