Clinical readiness for essential maternal and child health services in Kenya
A cross-sectional survey
Bibliographic Data
| ID | 19591810 |
|---|---|
| Authors | Jill M Hagey (0000-0003-1062-8371, University of North Carolina at Chapel Hill, corresponding author), Sandra Y Oketch (0000-0002-7328-0301, Duke University), Jeremy M Weber (0000-0002-7221-8821, Duke University), Carl F Pieper (0000-0003-4809-1725, Duke University), Megan J Huchko (0000-0002-4081-4768, Duke University) |
| Editors | Adriana Andrea Ewurabena Biney |
| Year | 2023 |
| Volume | 3 |
| Issue | 12 |
| Pages | e0002695 |
| Publication date | 2023-12-15 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | PLOS Global Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2767-3375 • E-ISSN: 2767-3375 |
| Publisher | Public Library of Science (PLoS) (PUBLISHER) |
| DOI | 10.1371/journal.pgph.0002695 |
| PMID | 38100395 |
| OpenAlex | W4389794994 |
| Language | EN |
| References cited | 24 |
High rates of maternal and neonatal morbidity and mortality in Kenya may be influenced by provider training and knowledge in emergency obstetric and neonatal care in addition to availability of supplies necessary for this care. While post-abortion care is a key aspect of life-saving maternal health care, no validated questionnaires have been published on provider clinical knowledge in this arena. Our aim was to determine provider knowledge of maternal-child health (MCH) emergencies (post-abortion care, pre-eclampsia, postpartum hemorrhage, neonatal resuscitation) and determine factors associated with clinical knowledge. Our secondary aim was to pilot a case-based questionnaire on post-abortion care. We conducted a cross-sectional survey of providers at health facilities in western Kenya providing maternity services. Providers estimated facility capacity through perceived availability of both general and specialized supplies. Providers reported training on the MCH topics and completed case-based questions to assess clinical knowledge. Knowledge was compared between topics using a linear mixed model. Multivariable models identified variables associated with scores by topic. 132 providers at 37 facilities were interviewed. All facilities had access to general supplies at least sometime while specialized supplies were available less frequently. While only 56.8% of providers reported training on post-abortion care, more than 80% reported training on pre-eclampsia, postpartum hemorrhage, and neonatal resuscitation. Providers’ clinical knowledge across all topics was low (mean score of 63.3%), with significant differences in scores by topic area. Despite less formal training in the subject area, providers answered 71.6% (SD 16.7%) questions correctly on post-abortion care. Gaps in supply availability, training, and clinical knowledge on MCH emergencies exist. Increasing training on MCH topics may decrease pregnancy and postpartum complications. Further, validated tools to assess knowledge in post-abortion care should be created, particularly in sub-Saharan Africa where legal restrictions on abortion services exist and many abortions are performed in unsafe settings
Abortion · Cross-sectional study · Environmental health · Family medicine · Health care · Health facility · Health services · Medical emergency · Neonatal resuscitation · Population · Pregnancy · Resuscitation · Global Maternal and Child Health · Maternal and fetal healthcare · Maternal and Perinatal Health Interventions · Medicine · Nursing · Emergency Medicine
Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030
Global causes of maternal death
Measuring movement towards improved emergency obstetric care in rural Kenya with implementation of the PRONTO simulation and team training program
Beneath the Surface
The effectiveness of training in emergency obstetric care
| Highly cited | No |
|---|