Senior research and business development manager, Innovations for Poverty Action, Nairobi, Kenya,
Assistant professor, University of California, Los Angeles Fielding School of Public Health, Los Angeles, CA, USA.
Int Perspect Sex Reprod Health. 2020 Jan 27;46:1-12. doi: 10.1363/46e8320.
A growing body of evidence indicates that nonclinical health care facility staff provide support beyond their traditional roles, particularly in low- and middle-income countries. It is important to examine the role of health facility cleaners in Kenya-from their perspective-to better understand their actual and perceived responsibilities in maternity care.
In-depth, face-to-face interviews using a semistructured guide were conducted with 14 cleaners working at three public health facilities in Nairobi and Kiambu Counties, Kenya, in August and September 2016. Results were coded and categorized using a thematic content analysis approach.
Cleaners reported performing a range of services beyond typical maintenance responsibilities, including providing emotional, informational and instrumental support to maternity patients. They described feeling disrespected when patients were untidy or experienced bleeding; however, such examples revealed cleaners' need to better understand labor and childbirth processes. Cleaners also indicated a desire for training on interpersonal skills to improve their interactions with patients.
Cleaners' direct involvement in maternity patients' care is an alarming symptom of overburdened health facilities, insufficient staffing and inadequate training. This key yet overlooked cadre of health care staff deserves appropriate support and further research to understand and alleviate health system shortcomings, and to improve the quality of maternity health care provision.
越来越多的证据表明，非临床医疗机构的工作人员除了履行传统职责外，还提供支持，尤其是在中低收入国家。从肯尼亚卫生设施清洁工的角度出发，研究他们的角色，以更好地了解他们在产妇护理方面的实际和感知到的责任，这一点很重要。
2016 年 8 月至 9 月，在肯尼亚内罗毕和基安布县的三家公立卫生机构，对 14 名清洁工进行了深入的、面对面的半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈，采用半结构式访谈。结果使用主题内容分析方法进行编码和分类。
清洁工报告说，除了典型的维护职责外，他们还提供了一系列服务，包括为产妇提供情感、信息和工具支持。他们描述了当患者不整洁或出现出血时，他们感到不被尊重；然而，这些例子揭示了清洁工需要更好地了解分娩和分娩过程。清洁工还表示，希望接受人际技能培训，以改善与患者的互动。
清洁工直接参与产妇护理是卫生设施负担过重、人员配备不足和培训不足的一个令人震惊的症状。这一关键但被忽视的医疗保健人员队伍需要得到适当的支持和进一步的研究，以了解和缓解卫生系统的缺陷，并提高产妇保健服务的质量。
