RP-Department of Community and Reproductive Health Nursing

Permanent URI for this collection

https://repository.ku.ac.ke/handle/123456789/18478

Browse

Now showing 1 - 14 of 14

Palliative Care Needs of Patients on Maintenance Hemodialysis at Thika Level 5 Hospital, Kiambu County, Kenya
(RJI, 2024-04) Githuku, Stephen N.; Onsongo, Lister; Mbuthia, Nickcy
Globally, a huge gap exists between the required and the available renal palliative care services. The gap is particularly worse in low-and-medium income countries despite having the highest percentage of patients requiring palliative care. Maintenance hemodialysis patients contribute a sizable percentage of the global renal patient population in need of palliative care. Successful provision of adequate palliative care services requires a holistic understanding of the patients’ needs. The purpose of this study was to explore the palliative care needs of patients on maintenance hemodialysis at Thika Level 5 Hospital. A qualitative descriptive design was used to explore the palliative care needs of the patients at the institution. Purposive sampling was used to recruit participants. Data collection was conducted for a period of one month at the hospital’s renal unit. A total of twelve maintenance hemodialysis patients participated in the study. Audiotaped semistructured interviews were used to conduct data collection. Thematic analysis was used to analyze the data. The study findings showed that maintenance hemodialysis patients have many palliative care needs. The needs regard to physical, psychological and social aspects. Distressing physical symptoms were identified as the primary physical needs where fatigue, skin changes and fluctuations in appetite were reported as the most prominent symptoms. Difficult thoughts related to uncertainty about the future, caregiver burden, inability to get more children, stress and worry as well negative self-image were reported as the psychological needs experienced by the patients. Interruption of social roles, abandonment by friends and financial burden on the family were revealed as the social needs of the patients. To deal with their illness and treatment related challenges, the patients primarily utilized spiritual coping where prayers were reported to be the most utilized coping method. Lack of knowledge on palliative care and fear of being judged were identified as patient related barriers to meeting palliative care needs of the patients. Understanding the palliative care needs of maintenance hemodialysis patients has important implications on practice and policy making. Findings could be used in developing renal palliative care services provision policies and protocols to use as a guide in the identification and provision of palliative care to maintenance hemodialysis patients. Also, nephrology nurses and other renal care team healthcare professionals could use the findings to develop strategies of addressing patient related barriers to meeting palliative care needs. For research, studies could be done to evaluate the influence and perspective of healthcare providers in the provision of palliative care to maintenance hemodialysis
Factors Influencing Quality of Life among Cancer Survivors in Kenya
(AJOL, 2022) Kung’u, Mary; Onsongo, Lister; Ogutu, James O
Background: The number of cancer survivors is growing continuously due to advances in treatment of cancer patients. In developed countries, numerous studies on quality of life (QoL) of cancer survivors have been conducted. Little is known regarding the QoL of cancer survivors in Kenya. Therefore, the aim of this study was to explore the factors that contribute to QoL of cancer survivors in Kenya. Methods: A descriptive cross-sectional design was used for the study. Participants were 108 adult cancer survivors. Self and interviewer administered QoL Patient/Cancer Survivor Questionnaire was used Results: Findings indicate a statistically significant relationship between QoL and age (rs =-.055 p<.05), marital status (rs=.490 p<.01), income (rs =.228 p<.05), stage of cancer diagnosis (rs =-.269. p<.01), year of cancer diagnosis (rs =-.295 p<.01), religious affiliation (rs =-.279, p<.01) and the religion one belonged to (rs =-.198 p<.05). Regression analysis showed that age, stage of cancer diagnosis, time off treatment, educational level, and religious affiliation are significant predictors of QoL in cancer survivors. Conclusions: The findings highlight the importance of key factors associated to QoL in cancer survivors in Kenya. Interventions aimed at early cancer detection, treatment, and spiritual support among cancer survivors will improve QoL
Effectiveness of a Facility-Based Health Education Intervention on Utilization of Emergency Obstetric and Newborn Care Services among Women of Reproductive Age in Nakuru County, Kenya
(IPRJB, 2023) Maingi, Nancy; Keraka, Margaret; Makworo, Drusilla
Purpose: Emergency obstetric and newborn care (EmONC) is the most important intervention to improve maternal survival. The study assessed facility based health education intervention on utilization of Emergency Obstetrics and Newborn care services. Methodology The study was a randomized control trial and utilized a mixed method. Multistage sampling was used. Key informants were purposefully selected Allocation to each study group was done on a 1:1 ratio; hence each group had 191 participants. The sample size was determined by Kelsey et al 1996 formula for calculation of sample size for randomized controlled trials and in order to take care of attrition 10% increase was done hence the sample size was 382 women. Pregnant mothers 26-32 weeks of gestation were enrolled. Structured questionnaire, focused group discussion and key informant interview schedules used. A pre-test was conducted at Kuresoi North Sub County. To ensure validity, research assistants were trained on the various research instruments. Descriptive statistics Fisher’s exact test at bivariate and odds ratio at multivariate analysis level were computed. Qualitative data was analysed using thematic content analysis. Ethical approval for the research was sought from the K.U research ethical committee, the National council for Science and Technology and Ministry of health. Informed consent was obtained from respondent prior to the study. Results: The intervention group had 95.93% (n =165) utilization of EmONC services in comparison to the control arm 75.29% (n = 128). There was no significance difference in the control group from base line to final survey OR 1.209, CI 0.742 to 1.969 and P-value 0.446. From the study findings the chances of EmONC services utilization after intervention was high. Those that received the intervention were seven times likely to utilize than those that did not receive the health education with an OR 7.734, 95% CI 3.363 to 17.787 and a P-value < 0.001 when we compare the intervention group and the control group. Unique Contribution to Theory, Practice and Policy: Administration of Health education is crucial in the utilization of EmONC services thus improving maternal mortality and morbidity. This study concurs with the Theory of Planned Behavior and the theory of Reasoned Action. Health education intervention may change the behavior intention of the client hence influencing utilization of EmONC services. It is recommended stakeholders to come up with a well-structured health education program in all regions of Kenya to improve emergency obstetric and newborn care services utilization.
Women's Experience of Unexpected Caesarean Section Birth in Kitui County, Kenya
(ahs, 2023) Kimanthi, Zipporah K; Onsongo, Lister N
Background: In sub-Saharan Africa, 72% of all Caesarean section (CS) births are unplanned compared to 27% of unplanned CS births done in developed countries. Various researches have been conducted on lived experiences following unexpected CS birth but none in Kitui County, Kenya. Objective: This study described the lived experience of undergoing an unexpected CS and the role of cultural beliefs on childbirth among Kitui/Kamba women in Kenya. Methods: A descriptive phenomenology design was used in this study. In-depth interviews of women who experienced unplanned Caesarean birth in Kitui County, Kenya, were conducted. Colaizzi’s method guided the analysis. Interviews were approximately 30 minutes long and audiotaped. Results: A total of 12 mothers participated in the study. Fives themes and 11 sub-themes emerged from this study: fear (fear of disability and surgical complications), pain (physical and psychological pain), less of a woman (lowered self-esteem, powerless and worry), sullied (dispirited and will loss), and fallacy (misconception and effects of fallacy). Conclusion: Disruption, dissatisfaction with the birth process, and unmet expectations were negative experiences. Healthcare workers should be sensitive when informing mothers of unplanned CS. More research to look for coping strategies to reduce negative birthing experiences.
Determinants of Implementation of Kangaroo Mother Care Services among Healthcare Workers in Makueni County,Kenya
(IPRJB, 2023) Matheka, Seraphine Mbinya; Kabue, Priscilla; Wanyoro, Antony; Muoki, Francis Matheka
Purpose: Kangaroo Mother Care (KMC) entails infants and mothers having constant skin-to-skin contact. KMC is done in the hospital after delivery to preterm infants or after early discharge. Mothers or caregivers are sensitized on proper positioning, breastfeeding, hygiene, and preventive measures to protect infants from infections. Proper follow-up is critical to ensure effective results are achieved. The use of KMC was endorsed by the World Health Organization (WHO) as routine care for preterm infants with a birth weight of ≤2000 grams, especially the clinically stable infants. This recommendation was based on the available moderate-quality evidence that it works by providing warmth (thermal care) and increasing breastfeeding opportunities irrespective of setting, birth weight, or gestational age. Also, KMC has been strongly acclaimed and used as a natural thermoregulator, infection prevention, and nutrition for preterm infants, which are critical for physiological functions that are strongly affected by physical immaturity. Although this technique offers quality care to these babies, its implementation is low. There is a need to determine the suitable methods to improve its implementation in Kenya's healthcare facilities. This study aimed to determine factors influencing the implementation of KMC in Makueni County health facilities. Methodology: The study was conducted in maternity units of six subcounty hospitals (Makueni county referral hospital, Makindu sub-county hospital, Kibwezi sub-county hospital, Mbooni sub-county hospital, Kilungu sub-county hospital, and Sultan-Hamud sub-county hospital) in Makueni County. Cross-sectional study design with mixed methods was used. Semi-structured questionnaires and KMC checklist were filled by the researcher and research assistants. The convenience sampling technique was carried out, and 90 healthcare providers and 6 Key Informants were interviewed. Data was analyzed using version 23 of a statistical package for social sciences using descriptive and inferential statistics. Findings: The study results reveal that young health care providers portrayed better KMC implementation compared to the old (r=-.210, p=0.047). In relation to gender, female health care providers had better KMC implementation compared to the male (r= -.290, p=0.006).Knowledge (r=.282, p=0.007) and health workers' perception of KMC (r=.245, p=0.02) had a positive and significant relationship with implementing KMC. Perception (β=1.149, p=0.05) and funds (β=0.958, p=0.05) had a positive and significant effect on implementing KMC. R squared indicated that jointly, age, gender, perception, and budget accounted for 29.4% of the overall variation in the KMC implementation. Results demonstrated a high level of KMC (33.3%) implementation among the health facilities. The study concluded that funds and collaboration had a positive and significant effect on implementing KMC. Unique Contribution to Theory, Practice and Policy: The study recommends that the hospital management should ensure there is provision of adequate resources to support KMC implementation. In particular, the hospital management should focus on strengthening physical and human resources. There is also a need to link all relevant programs, such as essential newborn care and Integrated Management of Neonatal and Childhood Illnesses (IMNCI), to support KMC implementation.
Facility Factors Influencing Utilization of Active Management of Third Stage Of Labour among Skilled Birth Attendants in Kiambu County, Kenya
(Supplement article, 2016-11-26) Felarmine, Muiruri; Joachim, Osur; Agina, Okello
Introduction: Post-Partum Hemorrhage (PPH) accounts for 34% of maternal deaths in Kenya. Active management of third stage of labour (AMTSL) is a World Health Organization and Ministry of Health of Kenya approved protocol for reducing maternal mortality and morbidity arising from postpartum hemorrhage. Kiambu County in Kenya records an average of six maternal deaths per month, out of which, two are due to PPH. This paper analyses how facility factors influence utilization of this protocol in Kiambu County. Methods: this was a cross sectional study among 431 skilled birth attendants in 52 health facilities. Two hundred and three birth attendants were selected using multistage sampling. Data was collected using questionnaires and observation checklists and analyzed using STATA version 11. Chi square, Fisher’s exact and Logistic regressions tests were used. Results: AMTSL was utilized by 31.5% of the birth attendants. Controlled cord traction (96.5%) was the most utilized. Uterine message after every 15 minutes was the least utilized component. Utilization was more in government facilities (37.4%) (Logistic regression p=0.006) and in level four health facilities (49.5%) (p<0.001). Utilization was higher (34.7%) among birth attendants who experienced less frequent stock outs (p=0.027) and in facilities with more than two staff authorized to order supplies (34.9%) (p=0.020). Utilization was higher in facilities with a fridge (44.5%) (p=0.001) and in facilities with standards documents in the labour ward (68.0%) (p=0.001). Conclusion: health facility factors significantly influence utilization of AMTSL and therefore the county government should put in place strategies to enhance the factors that influence utilization of AMTSL positively
Level of Knowledge among Adolescent Girls on Modern Contraception at Tsangano Turnoff Community, Ntcheu District, Malawi
(IPRJB, 2019) Damson, Ellen Chifundo; Keraka, M; Kabue, P
Purpose: The purpose of this study was to establish level of knowledge among adolescent girls on modern contraception at Tsangano Turnoff community, Ntcheu District, Malawi Methods: The study used a cross sectional study employing both simple random sampling technique for quantitative data and purposive random sampling technique for qualitative. The research instruments were self-administered questionnaires and Focused Group Discussions (FGD). Quantitative data was analyzed using Statistical Package for Social Sciences version 22.0. Analysis proceeded in two steps. First, univariate descriptive statistics were used to describe sample characteristics and estimate contraceptive prevalence among the adolescents. Contingency table methods were used to test associations between independent (categorical) variable and utilization of contraception and the qualitative data from the FGDs was transcribed and analyzed by thematic content analysis techniques. Results: This study found that a lot of adolescent girls had general knowledge regarding modern contraception as majority reported to have knowledge about modern contraception (73.9%). This study has shown that utilization increases with the increase in the level of knowledge as it has shown that out of the all the 54 respondents who reported to be utilizing modern contraception all of them had moderate to high knowledge regarding contraception. The results shows that utilization is highly significant statistically to knowledge as those respondents who had adequate knowledge they are four times more likely to utilize modern contraception than those who has little or no knowledge. Unique Contribution to Theory, Practice and Policy: The study recommended that Knowledge on modern contraception is very important in the utilization of the contraceptive hence since education is one way of empowering the girl child to be a reliable citizen in future therefore the high existing knowledge reported in this study should be encouraged and be related to utilization of modern contraception and other sexual and reproductive health services.
Home Deliveries in Rural and Urban Districts in Kenya
(paper publication, 2017-03) Kabue, Priscilla
Home deliveries is common in developing countries Kenya included where mothers are assisted by Traditional Birth Attendant during delivery. Most birth which occur at home can result in complications which cannot be handled in the absence of qualified health personel and a health facility. To reduce maternal mortality its important that mothers deliver in a hospital with qualified health personnel. Objective: The study aimed at establishing the factors that contribute to home deliveries in both rural and urban Districts in Kenya. Methodology: A cross sectional study design was preferred. A sample of four hundred postnatal mothers in Rural and Urban hospital attending maternal child health clinics were selected for the study. Eligibility was mothers who had delivered at home within one year prior to the study. Focus group discussion guides were used to collect data. Data was analyzed by correspondence and thematic analysis and presented in figures and summary narratives. Results: Most mothers in rural area delivered at home compared to urban 119 Mothers delivered at home in rural while only 47 did so in rural area. This is associated with lack of money and transport. Home deliveries are preferred because they are cheap, no cost of travelling, TBA have a positive attitude and use polite language, there is one to one care so chances of self-delivery do not arise and mothers are in familiar environment. Conclusion: Home deliveries are still common in Kenya despite availability of health services. Recommendation: Health worker should improve during delivery on the care they give to the mother irrespective of their socio-economic status
Role of Traditional Birth Attendants in Providing Pre and Postnatal Care to Mothers in Refugee Camps: A Case of Ifo Camp Dadaab Kenya
(med crave, 2021) Mwoma, Teresa; Kituku, Jacqueline; Gitome, Josephine; Kahumbi, Newton; Ndegwa, Priscila; Maina, Muthoni; Bagelman, Jen
Access to skilled birth attendance is critical in improving maternal and newborn health. However, in low resource settings, rural and refugee camps, professionally trained staff are often in short supply hence women tend to rely on traditional birth attendants (TBAs) for delivery. Despite knowledge that a health care facility delivery is safer, many women from low resource environments continue to seek for the care of TBAs. In order to understand the care provided to refugee women during pregnancy and after birth, in a refugee camp, a study was conducted in Ifo Dadaab refugee camp in Kenya. The aim of this article therefore, is to document findings on participants’ perspectives on pre and post-natal care provided to women in refugee camps during pregnancy and after birth. This was a qualitative study conducted in Ifo refugee camp in Dadaab Kenya. Nine participants were purposively selected for the study to give their perspectives on the role of TBAs in providing caregiving support to refugee women during pregnancy and after birth. The participants included two married men, three traditional birth attendants, two Somali pregnant women and two refugee safe mothers. Data was collected through focus group discussions and interviews. The data was beefed up with feedback from dissemination of preliminary findings to stakeholders’ validation conference held at Kenyatta University. Findings revealed that TBAs play a critical role in supporting women during pregnancy and after birth. However, they are not able to attend to complications associated to delivery. Among the caring support cited include, guiding and counselling pregnant women, educating them on the importance of attending antenatal clinics, massaging women during labour, praying for the baby after birth, and escorting women to the health facilities to take their babies for immunization. It was also apparent that TBAs advise pregnant women on the herbs they should have in stock while pregnant. In addition, they advise women to breast feed their babies immediately after birth. While TBAs are able to assist un complicated births at home, it was apparent that it becomes challenging for them to provide support for women with complication during the birth process. In view of this, it will be more helpful for TBAs to be encouraged to guide and advise pregnant women to deliver in the health care facility, where they can escort them to get professional attention during birth.
Prevalence and Risk Factors for Perineal Trauma among Women at a Teaching and Referral Hospital in Kenya
(IISTE, 2019) Kituku, Jacqueline; Getanda, Amos; Mwangi, Ann
Perineal trauma is classified according to the degree of structures involved or according to the depth of the injury. Mild perineal trauma is very common following vaginal delivery. Risk factors for perineal trauma include primiparity, precipitate labour, instrumental deliveries, pushing techniques and birth positions. Perineal trauma is associated with significant short-term and long-term complications. The objective of the study was to determine the prevalence and risk factors for perineal trauma among women at teaching and referral hospital in western Kenya. A cross-sectional study was carried out at the teaching hospital between April and May 2015. Two hundred and nine women who had come to deliver at the facility were consented to participate in the study. A structured checklist was used to obtain data from the women and make observations as skilled care givers attended to deliveries. All analyses were performed at 95% level of confidence. Two hundred and nine (209) deliveries were observed. Majority of the women, 76 (36.40%), were in the 20-24 age group. Ninety seven (46.10%) of them were para 0. Eighty one (38.8%) of the women sustained various types of perineal trauma. Supine position during delivery was the most preferred position, in 201 (96.2%), of the women. Age of the mother, parity, infant birth weight, and history of previous trauma, were statistically significant, associated with trauma in the univariate analysis (p=0.013; p=0.000; p= 0.010; p= 0.033) respectively. Adjusting for other factors, the odds of sustaining perineal trauma increased with increased birth weight (OR 2.878; p= 0.005) and decreased with increasing parity (OR 0.037; p=0.000). The prevalence of perineal tears as revealed by the study was 38.8%. This study recommended evidence based practice during labour and delivery in order to improve pelvic floor outcomes as well as reduce operative deliveries and long term morbidities.
Sexting and Risky Sexual Behaviour among Students in Machakos University, Machakos County. Kenya
(IPRJB, 2020) Mukonyo, Musyimi Elizabeth; Mugo, Judy; Kabue, Priscilla
Purpose: The purpose of this study was to investigate sexting practice among students and identify the risky sexual behaviors associated with sexting among students in Machakos University, Machakos County, Kenya. Methodology: The study adopted a descriptive cross-sectional study design. The target sample was 347 students aged 18-24 years in Machakos university. Convenience sampling was used for quantitative data and purposive sampling for qualitative data as well as the study area. Interviewer-administered questionnaires were utilized and in-depth interview used for the qualitative data collection. The IBM SPSS version 26.0 was used for data analysis. Thematic analysis was used to analyze the qualitative data and triangulated with quantitative findings. Results was presented in tables, graphs and pie charts. Chi square test was done to identify variables associated with sexting and odds ratio to measure the association between sexting and risky sexual behavior. Findings: Sexting (sending of sexually suggestive image/photo) was found to be prevalent among the student at 57% and 48% being two-way sexters. Male respondents engaged more into sexting as compared to female respondents at 67%and 33% respectively.23.0% sexted to keep or get a boy/girlfriend and 14% due to pleasure from their peers. Gender, Age, Level of study and relationship status were all significantly associated with sexting (P=0.000, P=0.027, P=0.002 and P=0.022 respectively). Risky sexual behaviors among students included early sexual intercourse 74%, but 54% had not used protection. Sexting and risky sexual behavior were found to be associated because most of the respondents who engaged in sexting were eight times more like to engage in early sexual intercourse, and the perception of sexters was that if one was sexting they were six times likely to have sex with the person they sexted, and so the null hypothesis that there is no relationship between sexting and risky sexual behavior was rejected and the alternative hypothesis adopted. Unique contribution to theory, practice and policy: Adoption of Multi sectoral to develop policies, and design youth programs with a wide range of issues relating to sex and sexuality and how to safely navigate the internet and form healthy relationships both on and offline, which include issues such as sexting with young people from a young age.
Professional Quality of Life among Nurses Caring for Cancer Patients
(Stratford Peer Reviewed Journals and Book Publishing, 2021) Gikonyo, Catherine W.; Onsongo, Lister; Ogutu, James O.
This study aimed at assessing the level and determinants of professional quality of life (compassion satisfaction, compassion fatigue, and burnout) for cancer care nurses. A descriptive correlation was conducted among 90 cancer care nurses using ProQoL Version-V and Brief COPE inventory self-administered questionnaires. Stratified sampling was used to select the study participants from different units. There was a high score for compassion satisfaction 42±4.76, low to average burnout 33±4.7, and compassion fatigue 27±8.7 scores. There was a statistically significant difference in the levels based on some demographic factors and personal factors. A negative relationship between compassion satisfaction with exposure to chemotherapeutic, workload, and insufficient preparation with Staff patient ratio was noted to be the major predicting factors for all subscales of ProQoL. Organizational and personal intervention measures such as self-care, a mentorship program for upcoming new oncology staff, and training cancer caregivers. A study with a large sample is highly recommended.
Utilization of Immunization Services among Children Aged Under Five in Kirinyaga County, Kenya
(International Journal of Community Medicine and Public Health, 2019) Njeru, Margaret W.; Kabue, Priscilla N.; Gachau, Albert G.
Background: Immunization is the key strategy to curb communicable diseases which are the number one killer of children under five years of age. Immunization prevents mortalities of approximating three million children under five years annually. This study aimed to assess utilization of immunization services among children aged under five in Kirinyaga County, Kenya. Methods: This was a descriptive cross-sectional study conducted among 388 participants in the five sub-counties of Kirinyaga County through systematic random sampling. Data was collected using a structured interview and review of recorded data from the Children immunization record card. Data was analyzed using SPSS and chi-square tests used to measure the association between independent and dependent variables. Statistical significance was set at p≤0.05. Results: Immunization at birth and at 6 weeks was highly utilized at 91%. However, there was a decline during the subsequent visits. Age, gender, profession and level of income were significant factors that affected timely immunization. Health service barriers to utilization included long ques and waiting time, stock out of vaccine and rescheduling of vaccination and clinic return dates. Other identified factors were myths and misconception, side effects, parity and lack of information. Conclusions: The results showed that utilization of immunization services was not in compliance with the expanded programme on immunization schedule. There is therefore need for health education programs to be carried out to improve utilization of immunization services and a door to door campaign to trace and immunize defaulters.
Nurse’s Knowledge Aspects of Enhancing Haemoglobin Level and Safety through Delayed Cord Clamping Time in a Semi-urban Hospital in South Rift Region, Kenya
(Kabarak Journal of Research & Innovation, 2019) Bor, Wesley; Mbithe, Dorcus; Ogada, Irene; Too, Wesley
The clamping of the umbilical cord can be done at different times after delivery, although delaying the clamping of the cord for ≥ 1 minute after birth improves the haemoglobin levels for newborn and variation may lead to safety issues and influence of the haemoglobin status of the infants. There is limited literature on the knowledge of health care providers on the optimal time to clamp the umblical cord after delivery. The objective was to assess the nurse’s knowledge aspect on enhancing haemoglobin levels through delayed cord clamping in a Semi Urban Hospital in South Rift Region, Kenya. The Participants nurses in the study were enrolled through simple random sampling in maternity and delivery rooms and the aspect of knowledge was assessed using Pre-test questionnaire. Half of the nurses (50%) had knowledge that delayed clamping is recommended. However, 69% had knowledge that delayed cord clamping should be performed for those infants requiring essential care under maximum safety conditions while 94% reported that delayed cord clamping is beneficial to the infant and does not interfere assessment of the baby and administration of uterotonic drugs. A bout 31% had incorrect knowledge that delayed umblical cord clamping increases the infant’s risk of acquiring HIV. Half of the nurses (50%) of nurses had knowledge that the World Health Organization (WHO) 2014 guidelines recommended delayed cord clamping for all infants without medical complications including infants of women who are HIV positive. The nurse’s knowledge on the optimal time to clamp the umblical cord after delivery was not uniform. Majority of the nurses had knowledge that delayed cord clamping increases the risk of mother to child HIV transmission and aspect of knowledge affected the safety level of infant haemoglobin levels. Relevant stakeholders should consider developing national guideline and standard operational procedures on Umblical Cord Clamping after delivery.

Browse

Recent Submissions