Background: Birth asphyxia accounts for one-third of neonatal mortality worldwide. Aims: To determine the prevalence of birth asphyxia and associated risk factors at one Kenyan hospital; and to describe caregivers' readiness for and attitudes towards neonatal resuscitation of asphyxiated neonates. Methods: A total of 237 babies and 28 health workers were consecutively enrolled as part of a longitudinal cross-sectional study. Prevalence of asphyxia, and caregivers' practices and attitudes were measured through observation. Risk factors were identified through interviews with mothers and a review of their medical records. Findings: Birth asphyxia prevalence hospital was 5.1%. Independent predictors of birth asphyxia were: duration of labour (OR=3.86; 95% CI; P=0.041), meconium staining of amniotic fluid, and presence of oedema in pre-eclampsia. Conclusions: Having equipment alone is not enough if providers are not equipped to use it. Neonatal resuscitation skils are therefore vital to eliminating neonatal mortality.
Although the World Health Organization (WHO) has recognised the role of male involvement in maternal and child health (MNCH), its uptake is still low ( WHO, 2001 ; Ramirez-Ferrero et al, 2012 ). Kenya's division for reproductive health has embraced male involvement to improve the local maternal mortality ratio (MMR) of 488 per 100 000 live births ( Kenya National Bureau of Statistics, 2010 ). Unfortunately, single ‘facilitative’ roles of men, such as escorting a wife to a health facility, have been mistaken for male involvement. This cross-sectional survey involving 388 married men used an index of seven proxy indicators to define male involvement in antenatal care. The index was used to find out the determinants of male involvement in the cosmopolitan Lang'ata district in Kenya. Scores of four and above out of the seven proxy indicators depicted more involvement compared to scores below four. Overall, there was 40% male involvement, and higher education (odds ratio (OR) 1.5, 95% confidence interval (CI): 1.05–2.03, p <0.026), planned pregnancies (OR 0.60, 95%CI: 0.46–0.76, p <0.001), high income (OR 0.51, 0.31, 95% CI: 0.30–0.72; p <0.001, 0.023), joint couple counseling and formalised marriages were associated with high male involvement in antenatal care.
Background: Ultrasound remains a tool of much importance in maternity care with midwives regarded as key health professionals when it comes to care of pregnant mothers. There is however limited study on the knowledge and skills gaps of midwives in conducting obstetric ultrasonography screening. The purpose of this study was to assess the specific obstetric ultrasonography knowledge and skills gaps among midwives based in primary health care facilities. Methods: A cross-sectional study employing both qualitative and quantitative method was conducted between July and August 2019 with 274 midwives. A structured questionnaire was used to collect data while Focus group discussion and Key Informants Interview were used to collect qualitative data. Descriptive statistics were used to summarize the data test associations between variables while the qualitative data were used to compliment the questionnaire data in eliciting more information on the gaps. Findings: Almost all (94.5%) the midwives had never been trained on any basic obstetric ultrasound while six of those that had been trained in early stages by the project lacked equipment to practice the acquired skills. More than three quarters of the respondents opined that they wished to provide personalized care services to mothers/clients seeking Antenatal Care Services (ANC) in their community at a fee while only 13.9% had knowledge that obstetric screening should be done before 24 weeks gestation. Four out of ten of the respondents scored themselves a one (1) on the level of confidence they have using an ultrasound machines or technology. Conclusion: There still remains a huge gap as far as training of midwives on basic ultrasound screening is
Background: To improve perinatal outcomes, many countries in Sub-Saharan Africa are introducing universal access to maternal and newborn care. In June 2013the government of Kenya introduced free maternity services in all public health facilities to increase skilled birth attendance. Facility-related determinants of perinatal outcomes in the context of free maternity care have not been well documented in the study area. Methods: Data based on biological variables, access to and quality of services was collected from mothers attending antenatal clinic (ANC) at the 1 st visit, 2 nd and 3 rd visits (which coincided with the 1
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