Prototyping to Practice: Validation of the Home Care Guide for Post-caesarean Mothers in Tanzania

Abstract

Background: The post-caesarean section (CS) home care guide was developed to ensure uniform and contextualised discharge education is provided by nurse midwives, especially in an era where CS rates are high and hospital stays are short. Early discharge limits mothers’ access to hospital-based care, increasing dependence on home care, which, without evidence-based guidance, can lead to complications. Currently, post-CS mothers receive insufficient education on post-CS home care, likely due to the absence of a standardised guide. This study aimed to validate the developed post-CS home care guide to ensure its contextual feasibility for use in Tanzania.
Methods: This was an iterative multi-stage validation design, involving 13 purposively recruited maternal and child health experts, 20 nurse-midwives, and 50 post-CS mothers in Dodoma and Morogoro regions, from 6th February to 15th May 2023. Participants were requested to evaluate the guide’s scope, language, dosage, applicability, clarity, timing, and frequency of use in teaching sessions. Descriptive statistics were used to analyse participants’ demographic characteristics and Likert scale responses. The Item-level Content Validity Index (I-CVI) and Item-face Validity Index (I-FVI) were computed for each component using SPSS version 25.
Results: The post-CS home care guide with 9 components was validated. The components are nutrition, wound cleaning and dressing, hygiene, maternal exercise and rest, breast care, regaining of sexual activity, adherence to prescribed medications and postnatal visits, use of family planning methods, and maternal mental health care. The 40-item guide demonstrated strong validity, with I-CVI scores between 0.83 and 1.0, and I-FVI scores of 0.76 to 1.0. No items were added or removed; minor edits were done to improve clarity based on participants’ recommendations.
Conclusion: The post-CS home care guide has been validated, as it offers a reliable, evidence-based tool for nurse-midwives to provide standardised, context-specific post-CS education to mothers and families, promoting safer recovery after CS delivery.