TY - JOUR
T1 - Health facilities preparedness to deliver maternal and newborn health care in Kilifi and Kisii Counties, Kenya
AU - Orwa, James
AU - Temmerman, Marleen
AU - Nyaga, Lucy
AU - Mulama, Kennedy
AU - Luchters, Stanley
N1 - Funding Information:
The endline surveys that collected data used for this study were funded by the Government of Canada and the Aga Khan Foundation Canada (AKFC) as part of AQCESS project which was implemented by the Aga Khan Development Network in partnership with the Government of Kenya. AKFC contributed to the design and data collection of the endline survey. The study was conducted as part of PhD training and the time to develop the concept, data analysis, and write-up was supported by the Office Of The Director, National Institutes Of Health (OD), the National Institute Of Biomedical Imaging And Bioengineering (NIBIB), the National Institute Of Mental Health (NIMH), and the Fogarty International Center (FIC) of the National Institutes of Health under award number U54TW012089 (Abubakar A and Waljee AK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
We would like to thank our community partners, study participants and end line research team in the two counties from the county ministry of health and projects. We are also grateful to the Government of Canada and AKFC for funding the AQQCESS project and for the Aga Khan Foundation Canada (AKFC) staff for the enormous time spend reviewing the end line study protocol and tools development.
Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - Introduction: Health facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end of the project implementation. Methods: A descriptive cross-sectional study was carried-out on behalf of AQCESS project team by respective county ministry of health in-charge of reproductive maternal newborn and child health programs and trained nurses and medical doctors from Aga Khan health services in December 2019. The study evaluated the accessibility and reliability of drugs, commodities, equipment, personnel, basic necessities (such as water and electricity), and guidelines using validated World Health Organization service availability and readiness assessment tool. The findings of the assessment are presented through frequency and percentage analysis, along with a comparative analysis between the two counties. Results: All the 16 facilities assessed offered routine antenatal care (ANC) and normal delivery, but only two provided comprehensive emergency obstetric and newborn care (CEmONC). Most essential medicines, commodities, and required equipment were available. BEmONC and CEmONC guidelines were present in Kilifi, not in Kisii. One staff member was available 24/7 for cesarean section (CS) in each county, with one anesthetist in Kilifi. Electricity was accessible in all facilities, but only half had secondary power supply. Facilities offering CS had backup generators. Conclusion: The Facilities assessed had necessary drugs, commodities, equipment, and requirements, but staffing and guidelines were limited. Kilifi outperformed Kisii in most indicators. Additional support is needed for infrastructure and human resources to deliver quality maternal and newborn health services. Continuous monitoring will facilitate resource allocation based on facility needs.
AB - Introduction: Health facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end of the project implementation. Methods: A descriptive cross-sectional study was carried-out on behalf of AQCESS project team by respective county ministry of health in-charge of reproductive maternal newborn and child health programs and trained nurses and medical doctors from Aga Khan health services in December 2019. The study evaluated the accessibility and reliability of drugs, commodities, equipment, personnel, basic necessities (such as water and electricity), and guidelines using validated World Health Organization service availability and readiness assessment tool. The findings of the assessment are presented through frequency and percentage analysis, along with a comparative analysis between the two counties. Results: All the 16 facilities assessed offered routine antenatal care (ANC) and normal delivery, but only two provided comprehensive emergency obstetric and newborn care (CEmONC). Most essential medicines, commodities, and required equipment were available. BEmONC and CEmONC guidelines were present in Kilifi, not in Kisii. One staff member was available 24/7 for cesarean section (CS) in each county, with one anesthetist in Kilifi. Electricity was accessible in all facilities, but only half had secondary power supply. Facilities offering CS had backup generators. Conclusion: The Facilities assessed had necessary drugs, commodities, equipment, and requirements, but staffing and guidelines were limited. Kilifi outperformed Kisii in most indicators. Additional support is needed for infrastructure and human resources to deliver quality maternal and newborn health services. Continuous monitoring will facilitate resource allocation based on facility needs.
KW - Community health systems
KW - Maternal child health
KW - Obstetric delivery
KW - Preparedness
KW - Quality of care
UR - http://www.scopus.com/inward/record.url?scp=85168253699&partnerID=8YFLogxK
U2 - 10.1186/s12913-023-09884-9
DO - 10.1186/s12913-023-09884-9
M3 - Article
C2 - 37587472
AN - SCOPUS:85168253699
SN - 1472-6963
VL - 23
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 868
ER -
