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Clinician attendance and delivery practices at hospital‐based vaginal deliveries in Western Kenya
Author(s) -
Patel Suha J.,
Bogaert Kelly,
Gachuno Onesmus W.,
Kibore Minnie W.,
Unger Jennifer,
Walker Dilys M.
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.09.010
Subject(s) - medicine , referral , attendance , confidence interval , family medicine , observational study , health care , vaginal delivery , nursing , tertiary referral hospital , obstetrics , pregnancy , retrospective cohort study , pathology , biology , economics , genetics , economic growth
Objective To characterize delivery practices and factors associated with respectful, evidence‐based care at a referral hospital in Western Kenya. Methods An exploratory observational study used a standardized birth‐observation form to record information on patient characteristics and healthcare practitioner behaviors during uncomplicated vaginal deliveries between June 30, 2014 and July 17, 2014. All deliveries were monitored for whether healthcare staff performed six specific evidence‐based practices (three maternal and three neonatal practices). Results In total, 75 vaginal deliveries were observed. In 48 (64%) deliveries, nursing students were the only practitioners present. The mean number of evidence‐based practices performed at each delivery was 3.58. The number of evidence‐based practices performed by junior practitioners was higher when a nurse educator was assessing their performance (4.47 vs 3.36, P < 0.001). Lower mean respectful‐care scores were recorded when delivery teams comprised three or more practitioners (1.38; 95% confidence interval 0.93–1.84 vs 2.74; 95% confidence interval 2.16–3.31, P = 0.002). Conclusion The present study found low rates of evidence‐based practice and respectful maternity care; this could serve as a deterrent for women seeking care at the study facility. These findings emphasize the need for a comprehensive approach in increasing the quality of patient care to improve maternal and newborn health outcomes.