Maternal Complications among Women Managed Through Focused Antenatal Care in Public County Hospitals in Nairobi City County, Kenya
Mukhwana, Raheli Misiko
MetadataShow full item record
Focused Antenatal Care is antenatal care that provides individualized counseling, targeted assessment and provides safe, cost effective, and evidence-based intervention. The noted public health major problem has been maternal mortality in developing countries. Majority of maternal deaths occur due to complication during pregnancy and eventual child delivery. The rate of maternal mortality was estimated at 686/100,000 live births in Sub-Saharan Africa. In Kenya maternal mortality rate is at 362/100,000 live birth. The implementation of Focused Antenatal Care was a strategy aimed at improving maternal health in developing countries. Utilization of Focused Antenatal Care has influenced pregnancy outcomes and this varies from country to country. This study therefore aimed at investigating maternal complications among women managed through Focused Antenatal Care in selected public county hospitals in Nairobi City County, Kenya. The study was conducted in postnatal wards of Mbagathi, Mama Lucy Kibaki and Pumwani Maternity Hospitals. The study adopted a cross-sectional descriptive study design. The study used quantitative and qualitative data collection methods. Quantitative data was collected using questionnaires administered to women in their postnatal period who had attended their antenatal care clinics at the selected public county hospitals. A total of 397 postnatal women were interviewed for the study. Qualitative data was collected using Key Informant Interview guides with 12 health care providers who were involved in provision of focused antenatal care services to clients. Quantitative data was analyzed using Statistical Package for Social Sciences to generate descriptive statistics and results presented as frequency tables, bar graphs, pie charts and percentages. Qualitative data from key informants was triangulated with quantitative data as direct quotes and narrations. Inferential statistics were done using Chi Square tests to determine the association between study variables at 95% confidence interval (p<0.05). Before data collection, the study sought approval from Kenyatta University Graduate School, ethical approval from Kenyatta University Ethics and Review Committee, research permit from the National Commission for Science, Technology and Innovation, research authorization from Nairobi City County, research permission from relevant hospital management and consent from study respondents. The study was conducted between 2nd January to 28th February 2019. The study results revealed that 30% of respondents reported to have encountered a maternal complication during their current delivery outcome. Socio-demographic factors such as age (p=0.002), occupation (p=0.001), income (p=0.011), number of deliveries (0.001) and mode of delivery (p=0.001) were significantly associated with maternal complications. The study results further revealed that 54.7% of respondents had high knowledge levels with 63.7% having positive attitude towards FANC utilization. Knowledge level of FANC was significantly associated (p=0.017) with maternal complications among respondents. The study concludes that the women managed through FANC from Nairobi City County had relatively low maternal complications with majority of socio-demographic characteristics playing a significant influence. The respondents further had high knowledge levels and positive attitude towards FANC utilization. These results would be of use to the Ministry of Health for purposes of health education, policy formulation and implementation concerning workable short and long-term maternal and child health interventions. This will ensure strict adherence to FANC utilization thus improved maternal outcomes during pregnancy and eventual child delivery.