Status of Health workers Knowledge on Maternal and Neonatal Health related to Service Delivery in Makueni County
Keywords:
Knowledge, prenatal, pre-eclampsia, postnatal, service delivery, health workers, Makueni County, KenyaAbstract
Introduction: Globally, new born mortality remains unacceptably high. Neonatal mortality accounts for 60% of infant mortality rate in Kenya. In Makueni County, 1 in 22 children does not live to his or her first birth day. This unacceptable high mortality is despite existence of cheap and tested interventions which could reduce up to 70% of current deaths. Evidence of mismanagement of clients in the County health facilities has raised concerns whether health workers attending to mothers and neonates are knowledgeable. The purpose of this study was to determine health worker knowledge on maternal and neonatal health related to service delivery in Makueni County. Specific objectives were to determine prenatal care, pre-eclampsia and postnatal care knowledge among primary care givers and how it relates to service delivery. Methods: we used a cross sectional research design. A total of 163 health workers selected through simple random sampling were involved. Data was collected using a structured questionnaire and observational checklist. Results: On prenatal care, majority of health workers (89, 54.6%) had good knowledge (x┬▓=45.1 p<0.05). Practice didnΓÇÖt conform to guidelines since 30.3% and 69.7% of antenatal mothers didnΓÇÖt have full history taken and general physical examination done respectively. On pre-eclampsia, majority of caregivers (78, 49.4%) had poor knowledge while on postnatal care (53, 32.5%), (58, 37.4%) and (132, 80%) had good knowledge in new-born care, management of neonatal infections and young infant feeding respectively. Conclusions: The study concluded that health workers were not following guidelines and lacked adequate knowledge in management of pre-eclampsia, new-born care and neonatal infections. Recommendations: The study recommends the following to Makueni County health managers (i) to have refresher course, targeted continuous medical education and standard operating procedure on management of pre-eclampsia (ii) to strengthen supportive supervision and ensure guidelines are adhered to (iii) to retrain workers on new-born care and management of neonatal infections.
References
Adetugbo, D. (1997). Socio-cultural factors and the promotion of exclussive breastfeeding in rural Yoruba communities of Osun State, Nigeria. Soc Sci Med, 113-125.
Aisien, A., & Shobowale, M. (2005). Health care workers knowledge on HIV and AIDs: Universal precautions and attitudes towards PLWHA in Benin city, Nigeria. Nigerian Journal of Clinical practice, 74-82.
Ayiasi, R., Criel, B., Orach, C., Nabiwemba, E., & Kolsteren, P. (2011). Primary healthcare worker knowledge related to prenatal and newborn care. Kampala: Makerere university.
Bhutta, Z., Ali, S., Samana, A., Cousens, S., Ali, T., Haider, B., . . . Black, R. (2008). Alma ata: rebirth and revision 6: interventions to address maternal, newborn and child survival: what difference can intergrated primary healthcare strategies make ? Lancet, 972-989.
Boller, C., Wyss, K., Mtasiwa, D., & Tanner, M. (2003). Quality and comparison of ANC in public and private providers in the United Republic of Tanzania. Bull World Health Organ, 116-138.
Conrad, P., Schmid, G., Tientrebeogo, J., Moses, A., & Kirenga, S. (2011). Compliance with focused antenatal care services. Tropical Med Int Health, 300-307.
Department Of Health MaKueni. (2013). Makueni County strategic plan 2013-2018. Wote: Author.
Eriksson, L., Nga, N., Malqvist, M., Persson, L., Ewald, U., & Wallin, L. (2009). Evidence-based practice in neonatal health: knowledge among primary healthcare staff in northern Vietnam. Hum Resour Health.
Esmai, & Songa. (1994). Health education on breastfeeding in ANC in Eldoret district hospital, Kenya. Scientific research, 149-154.
Esposito, S., Tremolati, E., Bellasio, M., Chiarelli, G., Marchisio, P., Tiso, B., & Mosca, F. (2007). Attitudes and Knowledge regarding Influenza vaccine among hospital health workers caring for women & children. Vaccine, 5283-5292.
Ganatra, H., & Zaidi, A. (2010). Neonatal infections in the developing world. semin perinatol, 416-425.
George, F., John, H., Apali, H., & Alsion, H. (2002). Evolving general practice consultation in Britain: issues of length and context. BMJ, 324-880.
Gortmaker, S. L. (1979). The effects of prenatal care upon the health of the newborn. American Journal of Public Health, 653-660.
Inke Mathaeur, I. I. (2006). Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Human Resources for Health, 1478-1491.
Ivan, K. D. (2013). Timing and reasons for coming late for the first antenatal care visit by pregnant women at Mulago hospital, Kampala Uganda. BMC Pregnancy and Child birth, 1471-2393.
Kenya National Bureau of Statistics. (2008). Kenya demographic and health survey. Nairobi: Author.
Kenya National Bureau of Statistics. (2009). Multiple indicator cluster survey. Nairobi: Author.
Lawn, J., Cousens, S., & Zupan, J. (2005). 4 million neoanatal deaths: when ? where ? why? Lancet, 891-900.
Lutwama, G., Roos, J., & Dolamo, B. (2012). A descriptive study on health workforce performance after decentralization of health services in Uganda. Kampala: Hum Resour Health.
Marjolein Dieloman, J. W. (2006). Improving health worker performance: In search of promising practices. Geneva: World Health Organization.
Martines, J., Paul, V., Bhutta, Z., Koblinsky, M., Soucat, A., Walker, N., . . . Costello, A. (2005). Neonatal survival: a call for action. Lancet, 1189-1197.
Mathole, T., Lindmark, G., Majoko, F., & Ahlberg, B. (2004). A qualitative study of women's perspective of antenatal care in rural area of Zimbabwe. Midwifery, 122-154.
Ministry Of Health. (2007). National reproductive health policy. Nairobi: Author.
Ministry Of Health. (2012). National guidelines for quality obstetrics and perinatal care. Nairobi: Author.
Ministry Of Health. (2013). Kenya service availability and readiness assessment mapping. Nairobi: Author.
Ministry Of Health. (2013). Paediatric protocol. Nairobi: Author.
Ministry Of Health. (2014, September 25). Kenya health information system. Retrieved from hiskenya.org: http://www.hiskenya.org
Mugenda, O., & Mugenda, A. (2003). Research Methods: Quantitative and qualitative approaches. Nairobi: Acts Press.
Okolo, S., & Ogbonna, C. (2002). Knowledge, attitude and practice of health workers in keffi local government hospitals regarding baby friendly hospital initiative practices. European Journal of clinical nutrition, 438-441.
Robert, A. N. (2013). Association between health worker motivation and healthcare quality efforts in Ghana. Human Resources for Health, 11-27.
Rowe, A., Savingy, D., Lanata, C., & Victoria, C. (2005). How can we achieve and maintain high-quality performance of health workers in low resource settings? Lancet, 1026-1035.
Sana, S., Rahat, Q., Asif, K., Rehana, S., Marrianne, V., & Diane, S. (2016). Health care provider knowledge and routine management of pre-eclampsia in Pakistan. Reproductive Health, 104.
Saugstad, O., Rootwelt, T., & Aalen, O. (1998). Resuscitation of asphyxiated newborn infants with room air or oxygen: An International controlled trial. Paediatrics, 102.
Shah, S., Rollins, N. C., & Bland, R. (2005). Breastfeeding knowlegde among health workers in rural South Africa. Journal of tropical paediatrics, Vol 51.
Shiffman, J. (2010). Issue attention in global health: the case of newborn survival. Lancet, 2045-2049.
Simkhada, B., Edwin, R., Maureen, P., & Padam, S. (2007). Factors affecting the utilization of ANC in developing Countries: A systematic review of the literature. Advanced nursing, 244-260.
Smith, S. (2013, April). Determining sample size: how to ensure you get the correct sample size. Retrieved from Qqualtrics: http://www.qualtrics.com
World Health Organization. (2006). World Health Report. Geneva: Author.
World Health Organization. (2007). Everybody business: strengthening health systems to improve health outcomes: WHOΓÇÖs framework for action. Geneva: Author.
World Health Organization. (2009). Optimal duration of exclusive breastfeeding . Geneva: Author.
World Health Organization. (2010). The Global strategy for womenΓÇÖs and childrenΓÇÖs health. Geneva: Author.
Yengo, M. (2007). Nurses perception about the implementation of FANC in district health facilities of Dar es Salaam. Cape Town: University of South Africa.
