School of Nursing and Public Health, Chuka University, Chuka, Kenya.
School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
Pan Afr Med J. 2023 Aug 4;45:149. doi: 10.11604/pamj.2023.45.149.36943. eCollection 2023.
INTRODUCTION: maternal mortality is a major health concern, especially in low and middle-income countries. In Kenya, about 362 maternal deaths occur in every 100,000 live births. Seventy-five percent of these deaths can be prevented through the provision of quality care, especially during labor and delivery as per the quality standards. The objective of this study was to establish the level of adherence to labor and delivery care quality standards among nurse-midwives, and the factors hindering the adherence. METHODS: a descriptive, cross-sectional survey was carried out in the maternity units of Embu and Meru Teaching and Referral hospitals in Kenya. A total of 51 Nurse-midwives were involved in the study. Data on adherence was collected through direct observation using an observation checklist, whereas that of factors hindering adherence was collected through face-to-face interviews using a semi-structured questionnaire. Data were checked, coded, and entered into EPI Info version 7.1.2. SPSS Version 25.0 was used to analyze data. Associations between variables were tested using Pearson correlation and Fisher's exact tests at 95% CI. RESULTS: most of the participants (60.7%, n=31) were diploma holders, and a half (51%, n=26) were aged 20-29 years. About half (51%, n=26) had practiced for between 1 and 9 years and 43.1% (n=22) had worked in the maternity unit for more than a year. Out of the 12 quality standards assessed, only 5 (41.7%) were adhered to. Major implementation challenges include unavailability of standards (n=98.0%, n=50), inadequate supplies (96.1%, n=49), inadequate knowledge (88.2%, n=45), and an overwhelming workload (86.3%, n=44). There is a significant correlation between the highest level of qualification and lack of knowledge of quality standards (r=-0.279, p=0.05). CONCLUSION: adherence to labor and delivery care quality standards is low among nurse-midwives. Stakeholders must allocate more resources for training and the provision of adequate supplies. The facilities should also source for and customize the quality standards to promote greater adherence.
简介：孕产妇死亡率是一个主要的健康问题，特别是在中低收入国家。在肯尼亚，每 10 万例活产中约有 362 例孕产妇死亡。通过提供优质护理，特别是在按照质量标准进行分娩和分娩期间，可以预防其中 75%的死亡。本研究的目的是确定助产士在遵守分娩护理质量标准方面的水平，以及阻碍遵守标准的因素。
方法：在肯尼亚埃姆布和梅鲁教学和转诊医院的产科病房进行了描述性的、横断面调查。共有 51 名助产士参与了这项研究。使用观察检查表通过直接观察收集关于遵守情况的数据，而使用半结构化问卷通过面对面访谈收集关于阻碍遵守的因素的数据。数据进行了检查、编码并输入到 EPI 信息版本 7.1.2 中。使用 SPSS 版本 25.0 分析数据。使用 Pearson 相关系数和 Fisher 精确检验在 95%置信区间内检验变量之间的关联。
结果：大多数参与者（60.7%，n=31）持有文凭，一半（51%，n=26）年龄在 20-29 岁之间。约一半（51%，n=26）有 1-9 年的实践经验，43.1%（n=22）在产科病房工作超过一年。在评估的 12 项质量标准中，只有 5 项（41.7%）得到遵守。主要的实施挑战包括标准不可用（n=98.0%，n=50）、供应不足（96.1%，n=49）、知识不足（88.2%，n=45）和工作量过大（86.3%，n=44）。最高资格水平与缺乏质量标准知识之间存在显著相关性（r=-0.279，p=0.05）。
结论：助产士遵守分娩护理质量标准的程度较低。利益相关者必须分配更多资源用于培训和提供充足的供应。这些设施还应寻找并定制质量标准，以促进更大程度的遵守。
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