The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: A quasi-experimental study

Autor: Mercy Wabomba, Duncan Ndombi Shikuku, Geofrey Tanui, Evelyne Atamba, Josephine Friday, Taphroze Peru, Kenneth Sisimwo, Dennis Wanjala
Rok vydání: 2020
Předmět:
Postnatal Care
Volunteers
medicine.medical_specialty
Maternal and newborn health care
Service delivery framework
Perinatal Death
Reproductive medicine
Skilled pregnancy and childbirth attendance
Midwifery
lcsh:Gynecology and obstetrics
03 medical and health sciences
Health services
0302 clinical medicine
Pregnancy
Health care
Quasi experimental study
medicine
Childbirth
Humans
030212 general & internal medicine
Community Health Services
lcsh:RG1-991
Perinatal Mortality
Hard-to-reach communities
030219 obstetrics & reproductive medicine
business.industry
Obstetrics
Infant
Newborn
Obstetrics and Gynecology
Prenatal Care
Patient Acceptance of Health Care
Stillbirth
medicine.disease
Community midwife
Kenya
Rural Kenya
Maternal Mortality
Strikes
Employee
Models
Organizational
Female
Rural Health Services
business
Program Evaluation
Research Article
Zdroj: BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-15 (2020)
DOI: 10.21203/rs.3.rs-27919/v2
Popis: BackgroundPoor women in hard-to-reach areas are least likely to receive healthcare and thus carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers’ strikes in rural Kenya.MethodsThe study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods: December 2016-February 2017 when doctors were on strike (P1), March-May 2017 when no healthcare providers were on strike (P2), and June-October 2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies/means of maternal and newborn health service utilization data across the three periods.ResultsThe monthly average number of clients obtaining services from CMs across the three time periods was: first antenatal care (ANC) (P1-1.8, P2-2.3, P3-9.9), fourth ANC (P1-1.4, P2-1.0, P3-7.1), skilled birth (P1-1.5, P2-1.7, P3-13.1) and the differences in means were statistically significant (p p p > 0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3 accompanied by a statistically significant decline in the average number of clients obtaining services from health facilities (p p ConclusionsThe findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.
Databáze: OpenAIRE
Externí odkaz: