Effect of Education on Adherence to Recommended Prenatal Practices among Indigenous Ngäbe-Buglé Communities of Panama

Abstract

Background and Objectives: The primary objective of this study was to assess the adherence of Ngäbe-Buglé women to WHO-recommended prenatal practices. The secondary objective was to compare adherence levels between women who received prenatal education from official medical providers and those educated through traditional or community-based sources within Ngäbe-Buglé communities. Materials and Methods: An eight-question survey was verbally administered to 137 Ngäbe-Buglé women at clinics set up by the non-profit NGO Floating Doctors in eight communities. A two-sided Fisher's Exact test with a p = 0.05 was used to compare the results of mothers who received prenatal education from evidence-based sources to other groups. Results: Out of the 137 surveyed women, 65 reported taking prenatal vitamins, 21 had prenatal check-ups, 136 avoided alcohol, 31 increased caloric intake, and 102 maintained their activity levels. Significant differences were observed in prenatal vitamin adherence between those educated by official sources versus unofficial sources (p = 0.0029) and official sources compared to those with no prenatal education (p < 0.0001). The difference was also significant for education from an unofficial source versus no education (p = 0.0056). However, no significant differences were found in other prenatal practices based on education sources. Conclusions: Our findings highlight deficiencies in both prenatal education and adherence to recommended practices among Ngäbe-Buglé women. Prenatal education significantly improved adherence to taking prenatal vitamins, suggesting its effectiveness as an intervention. Future interventions should prioritize culturally competent prenatal education and address barriers to accessing prenatal healthcare in Ngäbe-Buglé communities.

Keywords: Panama health; indigenous peoples; maternal and child health; prenatal care; prenatal education.

Figure 1

Total Responses to Survey Stacked Bar Graph. Categories of compared responses include Took Prenatal Vitamins (65Y, 72N), Obtained Prenatal Check-up (21Y, 116N), Avoided Alcohol (136Y, 1N), Increased Caloric Intake (31Y, 106N), Maintained Activity Level (102Y, 35N).

Figure 2

Source of Prenatal Education Pie Chart. Sources of prenatal education include family members (26), community members (21), Floating Doctors (12), Ministry of Health (26), or no education (52).

Figure 3

Adherence to Taking Prenatal Vitamins Stacked Bar Graph. Categories of compared responses include those who have received official education (31Y, 7N), those who received unofficial education (23Y, 24N), and those who did not receive any type of prenatal education (11Y, 41N). The difference in totals was found to be statistically significant (p < 0.0001).

Figure 4

Adherence to Taking Prenatal Vitamins in Groups Educated by Various Sources Stacked Bar Graph. The yes or no responses of participants to taking prenatal vitamins during pregnancy were compared by source of education received, including those who were educated by an unofficial source such as family member (11Y, 15N) or community member (12Y, 9N), those who were educated by an official source such as the Floating Doctors (9Y, 3N) or Ministry of Health (22Y, 4N), and those who received no education at all (11Y, 41N).