Accessibility and Health Facility Factors Influencing Maternal and Fetal Outcomes among Mothers Referred with Obstetric Emergencies in Baringo County Referral Hospital, Kabarnet, Kenya

Authors

  • Kandie Phylis Jebii Nursing Officer: Moi Teaching and Referral Hospital, Eldoret,Kenya

DOI:

https://doi.org/10.47604/jhmn.1723

Keywords:

Obstetric Emergencies, Accessibility Factors, Health Facility Factors, Maternal and Fetal Outcomes

Abstract

Purpose: To determine the accessibility to a health facility and health facility factors influencing maternal and fetal outcomes among mothers referred with obstetric emergencies in Baringo County referral Hospital.

Methodology: A descriptive cross-sectional study which employed a mixed method approach of data collection was adopted. Simple Random technique was used in selecting 284 respondents into the study. The study population also included nurses, gynaecologist and medical officers who were purposively sampled. Qualitative data collection was analysed through content analysis while descriptive and inferential statistics were used to analysed quantitative data. 

Findings: results show that mothers who are accompanied by nurse are 4.3 times more likely to have complications than those accompanied by relatives (AOR:4.3;95% CI:1.2-16.1;p=0.03). Moreover, mothers who were coming from distant health facilities were 70% less likely to have experience complications than those who live closer to the referral hospital (AOR: 0.3; 95%CI: 0.1-1.1; p=0.07). Neonates whose mothers received treatment within 30 min (OR: 0.5; 95% CI: 0.3 - 0.8; p = 0.005) were 50% less likely to have had abnormal outcome. In contrast, the risk of abnormal outcome was higher for neonates whose mothers received treatment before referral (OR: 2.3; 95% CI: 1.4 - 3.8; p = 0. 001) suggesting possible delay in providing treatment as a possible cause of deteriorating condition of the foetus. Mothers who stated that nurses listened and explained things (3.9%) or those seen within less than 30 minutes to be attended to (p = 0.3) experienced complications. On the other hand, the odds of complications increased where the main reason for referral was lack of expertise and equipments at the referring health facility (p = 0.09) though the result was not statistically significant.

Unique Contribution to Theory, Practice and Policy: This study has identified accessibility and health facility factors influencing the obstetric emergencies in a marginalized county. The study will provide insight to policy maker's hence evident-based interventions will be made. No literature review has been published on this topic at the study site therefore, this study will form a basis for other researchers.

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References

Anju A, Rashmi B. M. ,Latha V, (2018) Maternal outcomes among emergency obstetric admissions at a tertiary care teaching hospital in Chitradurga, South India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology Arpana A Int J Reprod Contracept Obstet Gynecol 7(12):4906-4911.

Cooper, D.R., Schindler, P.S. (2011) Business research methods. New York: McGraw-Hill companies, 7th ed

Cronbach, L. J. (1971). Test validation. Educational measurement.

Dawson, C. (2002). Practical research methods: A user-friendly guide to mastering research. How to books.

Echoka, E., J. (2014). Barriers to emergency obstetric care services: accounts of survivors of life-threatening obstetric complications in Malindi District, Kenya. The Pan African medical journal, 17(Suppl 1).

Gacheri, A. (2016). Tackling high maternal deaths in Kenya. Policy Brief, Parliament of Kenya.

Geleto A, Chojenta, C, Mussa , & Loxton D, (2018) Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol. US National Library of Medicine National Institutes of Health, 6;7(1):60.

Gitonga, C. (2013). The state of the health referral system in Kenya: results from a baseline study on the functionality of the health referral system in eight counties. Masters Thesis Kenyatta University

Gopinath, S. (2016). Six decades of project management research: Thematic trends and future Maternal Health. International Journal of Health Research, 34(7), 1305-1321.

Gopinath, S., Shafi, M., Ramegowda, H. K., & Mehta, P. K. (2016). Outcome of Referred Obstetric Emergencies at a Tertiary Center. Int J Biol Med Res, 7(2), 5518-5521.

Green, J., & Thorogood, N. (2009) In-depth interviews. Qualitative methods for health research,2, 93-122.

Jakhar, R., & Choudhary, A. (2019). Study of maternal outcome in referral obstetric cases in a tertiary care centre. Journal of Family Medicine and Primary Care, 8(9), 2814.

Jebet, J., & Oyore, J. P. (2015). Poor pregnancy outcomes in public health facilities in Kenya, (October 2012), Age, 4-10.

Jyotsana, L, D. & Vohra,H, (2017) Maternal and perinatal outcome of referred patients in tertiary health centre. International journal of reproduction, obstetrics, contraception and Gynecology,6(12) 7-15

Kim, Y. (2011). The pilot study in qualitative inquiry: Identifying issues and learning lessons for culturally competent research. Qualitative Social Work, 10(2), 190-206.

Kombo, R., & Tromp, S. (2009). Business Research Methods 10thedition.

Kumsa, A., Tura, G., Nigusse, A., & Kebede, G. (2016). Satisfaction with emergency obstetric and new born care services among clients using public health facilities in Jimma Zone, Oromia Regional State, Ethiopia; a cross sectional study. BMC pregnancy and childbirth, 16(1), 85.

Laroca, F. H. B., Galeto, P. H., & Klippel, Y. M. (2018). Programa Saiba: Conscientização Crítica Frente Ao Consumo De Substâncias Psicoativas. Anais da Jornada Científica dos Campos Gerais, 16.

Lule, V. K., Garg, S., Pophaly, S. D., & Tomar, S. K. (2015). Potential health benefits of lunasin: a multifaceted soy"derived bioactive peptide. Journal of Food Science, 80(3), R485-R494.

Mannava, P., Durrant, K., Fisher, J., Chersich, M., & Luchters, S. (2015). Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review. Globalization and health, 11(1), 1-17.

Masaba, B. B., & Mmusi-Phetoe, R. M. (2020). Neonatal survival in Sub-Sahara: a review of Kenya and South Africa. Journal of multidisciplinary healthcare, 13, 709.

Masaba, B. B., & Mmusi-Phetoe, R. M. (2020). Neonatal survival in Sub-Sahara: a review of Kenya and South Africa. Journal of multidisciplinary healthcare, 13, 709.

Mugenda, A. (2008). Social science research: Conception, methodology and analysis. Nairobi: Kenya Applied Research and Training Services, 10(1).

Ntoimo LF, Okonofua FE, Ogu RN, Galadanci HS, Gana M, Okike ON, Agholor KN, Abdus-Salam RA, Durodola A, Abe E, Randawa AJ, (2018) Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria: a multicenter study. Int J Womens Health. 2018; 10: 69-76.

Obossou, A. A. A., Tognifode, M. V., Brun, L., Balle, M. C., Denakpo, J. L., Akpo, E. M., ... & Perrin, R. X. (2017). Epidemiology and Management of Gynecological and Breast Cancers in the Two Reference Hospitals of Parakou, in North Benin. Oncology & Cancer Case Reports, 3(2), 1-5.

Prasad D, Nishat H, Tiwary B, Swet N, Sinha A, Goel N. Review of obstetrical emergencies and fetal out come in a tertiary care centre. International Journal of Research in Medical Sciences. 6(5):1554-1558.

Ryan, G. W., & Bernard, H. R. (2003). Techniques to identify themes. Field methods, 15(1), 85-109.

Saldana, J. (2009). An introduction to codes and coding. The coding manual for qualitative researchers, 3.

Serech, P., Githuku, M., Gura, B., & Ochieng, J. (2018). Factors Influencing Maternal And Fetal Outcomes Among Mothers Reffered With Obstetric Emergencies. Journal of Health, Medicine and Nursing, 6(1), 53-67.

Shneiderman, B., & Plaisant, C. (2006, May). Strategies for evaluating information visualization tools: multi-dimensional in-depth long-term case studies. In Proceedings of the 2006 AVI workshop on BEyond time and errors: novel evaluation methods for information visualization (pp. 1-7). ACM.

Smith, R, J, (2018) Postpartum Hemorrhage: Background, Problem, Epidemiology. American College of Obstetricians and Gynecologists, College of physicians and surgeons of Ontario. Canada

Thaddeus S, Maine D.(1994) Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38(8):1091-10.

Thaddeus S, Maine D.(1994) Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38(8):1091-10.

Turner, J. C. (2010). Social categorization and the self-concept: a social cognitive theory of group behavior.

Verma, K, Girish C, B, Sudesh, A, Shailendra L, (2016) Maternal and perinatal outcome in eclampsia patients Journal of Obstetrics and Gynecology Research 2016;3(4):318-321

WHO (2014) Mother-package: Implementing of the Safe Motherhood in developing countries, Geneva, 2010.

WHO, (2016) Standards for Improving Quality of Maternal and Newborn Care in Health Facilities

WHO,(2015). Trends in Maternal Mortality: 1990-2014- Estimates by WHO, UNFPA, UNICEF, The World Bank and the United Nations Population Division Geneva: World Health Organization; 2015.

Yeshialem E, Alemnew N, Abera M, Tesfay A (2017) Determinants of Adverse Pregnancy Outcomes among mothers who gave birth from Jan 1-Dec 31/2015 in Jimma University Specialized Hospital, Case control study, 2016. Med Clin Rev. 3(4)22.

Zikmund-Fisher, B. J., Couper, M. P., Singer, E., Levin, C. A., Fowler Jr, F. J., Ziniel, S., ... & Fagerlin, A. (2010). The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. Medical Decision Making, 30(5), 20-34.

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Published

2022-12-21

How to Cite

Kandie, P. (2022). Accessibility and Health Facility Factors Influencing Maternal and Fetal Outcomes among Mothers Referred with Obstetric Emergencies in Baringo County Referral Hospital, Kabarnet, Kenya. Journal of Health, Medicine and Nursing, 8(2), 65–85. https://doi.org/10.47604/jhmn.1723

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