Puerperal infection is a type of complications that poses a major threat to the mother's and baby's lives after birth, that occurs during childbirth or within 42 days of the postpartum period. This period may receive less attention than during pregnancy and childbirth. Primigravida women become unaware of their health at delivery time, this leads to a large number of negative consequences due to a lack of knowledge of preventive measures.

1. ‫قال‬
‫هللا‬
‫تعـــــــــالى‬
:
ِ
‫ل‬ُ‫ق‬َ‫﴿و‬
‫وا‬ُ‫ل‬َ‫م‬ْ‫ع‬‫ا‬
‫ى‬َ‫ر‬َ‫ي‬َ‫س‬َ‫ف‬
ِ
ُ َ
‫اّلل‬
ِ
ْ‫م‬ُ‫ك‬َ‫ل‬َ‫م‬َ‫ع‬
َِ‫ر‬َ‫و‬
ِ
ُ‫ه‬ُ‫ل‬‫و‬ُ‫س‬
َِ‫ون‬ُ‫ن‬‫م‬ْ‫ؤ‬ُ‫م‬ْ‫ل‬‫ا‬َ‫و‬
ِ
ُ‫ت‬َ‫س‬َ‫و‬
َِ‫ُّون‬‫د‬َ‫ر‬
‫ى‬َ‫ل‬‫إ‬
ِ
‫م‬‫َال‬‫ع‬
ِ
‫ب‬ْ‫ي‬َ‫غ‬ْ‫ل‬‫ا‬
ِ
‫َة‬‫د‬‫ا‬َ‫ه‬َ‫ش‬‫ال‬َ‫و‬
ِ
ْ‫م‬ُ‫ك‬ُ‫ئ‬‫ب‬َ‫ن‬ُ‫ي‬َ‫ف‬
‫ا‬َ‫م‬‫ب‬
ِ
ْ‫م‬ُ‫ت‬ْ‫ن‬ُ‫ك‬
‫ون‬ُ‫ل‬َ‫م‬ْ‫ع‬َ‫ت‬
﴾
‫صدق‬
‫هللا‬
‫العلي‬
‫العظ‬
‫يم‬
‫اآلية‬
‫رقم‬
(
١٠٥
) ‫سورة‬
‫التوبة‬

2. Effectiveness of an instructional program on
pregnant women's knowledge toward puerperal infections
at Al-Najaf City
By
Thikra Abdul Kadhim Abdulhussein
Supervised by
Prof. Dr. Shukriyia Shadhan Chayad
Prof. Dr. Rajha Abdul Hassan Hamza

3. Problem Statement
The problem of the current work tackles entitle
(Effectiveness of an instructional program on pregnant
women's knowledge regarding Puerperal infections at Al-
Najaf City).

4. Introduction
The postnatal period (puerperium) is a very important
period. During this time, the mothers are at risk of various
complications, which can lead to severe illness or death. One
of the primary causes of maternal death is puerperal
infections.
Puerperal infections are bacterial infections that occur after
the childbirth. They cover not just infections of the genital
tract, but also all extra-genital infections and accidental
infections: Infections of the genito-urinary systems
associated with labor, delivery, and the puerperium,

5. continue …
Infections related to the uterus and its associated structures,
Infections related to the urinary tract, Infections specifically
related to the birth process but not of the genito-urinary
system, such as breast abscess or (mastitis), as well as
incidental infections, such as respiratory tract infections and
others.
All of these postpartum infections are mostly reported after
hospital discharge. As a result, the prevalence of infections
has been reported at various levels, depending on healthcare
systems, healthcare availability, and surveillance methods.

6. Objectives of the Study
1. To identify the level of women's knowledge about
puerperal infection.
2. To determine the effect of the instructional program on the
level of women's knowledge toward puerperal infection
by comparing between pre-test and post-test.
3. To find out the relationship between women's level of
knowledge and certain variables (socio-demographic,
reproductive, and source of information).

7. Methodology

8. sample
A purposive
sample of 50
primigravida
Design of
study
A quasi-
experimental
Primary Health
Care centers
(6PHCcs) in
the northern
and southern
sectors at Al
Najaf city
Tool
Questionnaire
includes(4parts)
Methodology
Methods
collect data
Interview
face to face
by
questionnaire
Setting

10. Table 1: Statistical distribution of demographic data of the study sample
Demographic data
Statistics
F (N=50) %
Age / Years
< 20 7 0.14
20-24 23 0.46
25-29 16 0.32
30-34 4 0.8
Total=50
Educational Status
No read and write 6 0.12
Primary 12 0.24
Secondary 15 0.30
Institute and above 17 0.34
Total=50
Residence
Urban 42 0.84
Rural 8 0.16
Total=50
Monthly Income
Sufficient 12 0.24
Barely Sufficient 34 0.68
Insufficient 4 0.8
Total=50
Occupational Status
Housewife 44 0.88
Employed 6 0.12
Total=50
Type of family
Nuclear 12 0.24
Extended 38 0.76
Total=50
BMI
Underweight 2 0.4
Normal weight 44 0.88
Overweight 4 0.8
Total=50

11. Table 2: Descriptive statistics of reproductive data of the study sample
Reproductive data
Statistics
F (N=50) Percentage
Age at marriage / Years
16- 20 29 0.58
21-25 17 0.34
26-30 4 0.8
Total=50
Abortion
Yes 18 0.34
No 32 0.64
Total=50
Stillbirth
Yes 5 0.10
No 45 0.90
Total=50
Visiting Health Center at pregnancy
Yes 50 0.100
No 0 0.0
Total=50
Number of antenatal visits during the current pregnancy
≥4 17 0.34
<4 33 0.66
Total=50
Gestational age of the third trimester
28–32 weeks 28 0.56
33–37 weeks 11 0.22
38 weeks and above 11 0.22
Total=50
Planning the method of delivery
Vaginal delivery 40 0.80
Cesarean delivery 10 0.20
Total=50
Scheduled place of delivery
At home 1 0.2
In the Hospital 49 0.98
Total=50

12. Table 3: Descriptive statistics of source information of the study sample
source of information
Statistics
F (N=50) %
Have gotten information about puerperal
infection?
Yes 38 0.76
No 12 0.24
Total=50
Source of Information
Physicians and nurses 4 0.8
Family and relative 31 0.62
Mass media 3 0.6
Total=50

13. Table 7: The overall mean of scores of women’s knowledge about puerperal
infection and differences between (pre-test and post-test) measurements
Overall Knowledge
Tests Mean SD Paired T-Test df P-value
Pre-test 1.51 0.37
9.20 29
0.000
HS
Post-test 1.95 0.12
HS: high significance at P<0.01

14. Figure (1): women’s knowledge assessment between (pre-test and post-test)
measurements

15. Table 9: ANOVA table for the association between the overall assessment of women’s knowledge
regarding Puerperal infection and their demographic data
Demographic data Mean SD F Test P-value
Age / Years
< 20 1.36 0.13
8.81 0.00
20-24 1.45 0.14
25-29 1.62 0.09
30-34 1.41 0.20
Educational Status
No, read and write 1.27 0.05
32.44 0.00
Primary 1.38 0.08
Secondary 1.50 0.10
Institute and above 1.64 0.10
Residence
Urban 1.51 0.15
7.76 0.01
Rural 1.36 0.14
Monthly Income
Sufficient 1.52 0.16
0.06 0.06
Barely Sufficient 1.50 0.15
Insufficient 1.32 0.06
Occupational Status
Housewife 1.51 0.12
9.22 0.00
Employed 1.66 0.05
Type of family
Nuclear 1.50 0.17
0.04 0.84
Extended 1.49 0.15
BMI
Underweight 1.43 0.28
0.14 0.87
Normal weight 1.49 0.16
Overweight 1.48 0.06

17. Conclusions
1. Most pregnant women have moderate knowledge about
puerperal infections.
2. There is a good enhancement in women’s level of
knowledge in the posttest as compared to their pretest.
3. Age, educational level, residency, and occupational status
have a positive relationship with the knowledge level of
pregnant women while other socio-demographic
characteristics of the study sample have no effect.

18. 4. Young pregnant women with ages less than 25 years are
the highest sample included in the study.
5. Most of the women in the study lived in urban areas. and
had sufficient income to some extent.
6. Majority of participants had a institute and above
educational level but still they are housewives.
7. There is a strong effect of the Instructional program on
improving Primigravida women’s knowledge regarding
Puerperal infections.

20. Recommendations
1. Collaborative work between the Ministry of Health and
the Ministry of Higher Education to include in their
curriculum knowledge related to risk factors that lead to
puerperal infections.
2. Providing the health centers with brochures (Appendix
E2), posters, and instructional program booklets
(Appendix E1) including instructions to prevent puerperal
infections to be available for pregnant women who visit
the health centers.

21. (Appendix E1)
‫النفاس‬ ‫التهابات‬ ‫أو‬ ‫عدوى‬ ‫حول‬ ‫الحوامل‬ ‫للنساء‬ ‫االرشادي‬ ‫البرنامج‬
ِِ‫اشرافِاألستاذِالدكتورة‬
‫أ‬
.
‫د‬
.
ِِ‫شكريةِشدهانِجياد‬
‫أ‬
.
‫د‬
.
ِ‫راجحهِعبدِالحسن‬
‫حمزه‬
ِِِ‫اعدادِطالبةِالماجستير‬
‫ذكرىِعبدِالكاظمِعبدِالحسين‬
ِ‫فرعِصحةِاالم‬
‫والوليد‬
2021
-
2022

22. (Appendix E2)

23. 3. Increasing the quality and quantity of primary health care
services by increasing the number of primary health care
centers where they must be well-equipped and provide
them with a sufficient number of highly skilled health
personnel, and this encourages an understanding of the
importance of health care for mothers and the health of
their children.
4. Further survey studies including all governorates are to
be conducted to assess the knowledge and practice of
mothers during the postpartum period.