Utilization of Continuum of Care and Prevalence of Puerperal Sepsis among Postnatal Mothers in Kericho County, Kenya
Kipkirui, Beatrice Chelangat
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Maternal and infant mortality is a critical issue that has been a herculean challenge to governments all over the world and especially in less developed nations. The continuum of care is reportedly one of the major strategies of addressing this challenge. This study sought to put into perspective the various factors that influence the continuum of care (COC) practices and how the said practices influence occurrence of puerperal sepsis among postnatal mothers. The specific objectives included to determine the prevalence of puerperal sepsis amongst PN mothers, to determine the utilization of COC amongst postnatal mothers, to determine the factors affecting utilization of COC; and to determine COC association with puerperal sepsis. Literature on the contributing factors, continuum of care practices and occurrence of puerperal sepsis was reviewed, critiqued and research gaps outlined. A cross-sectional research design and a mixed approach were adopted. Positivism paradigm guided the study. The study variables included maternal factors, and health facility-related and occurrence of puerperal sepsis. The study was conducted in Kericho County where participants were postnatal mothers and health care workers. A sample of 385 postnatal mothers and8 postnatal mothers was considered by the study. A structured questionnaire and focus group discussion guide were used as tools for data collection. The tools were pretested with the view of assessing their validity and reliability. The collected data were analyzed using the Statistical Package for Social Sciences tool. Descriptive and inferential statistics were used in the analysis. Pertinent logistical and ethical issues were considered. The findings indicated that in reference to adherence to the compliant of care practices, the mothers preferred to give birth at health facilities (95.2%). This notwithstanding, the completion of the continuum of care was not realized by the mothers in Kericho County. Although affordable, some mothers were deterred from seeking necessary continuum of care services from health facilities due to staff inadequacy and lengthy distance. The continuum of care practices was found to explain 83.1% variability in the occurrence of puerperal sepsis. It was also indicated that the effect of the continuum of care practices on occurrence of puerperal sepsis was statistically significant at p<0.001. The study concluded that the surveyed mothers did not complete the continuum of care since only a few attended ANC with majority opting to deliver at health facilities and attend PNC. Puerperal sepsis occurred while the mothers were at home not in the hospital. It is recommended that there ought to be more awareness on matters reproductive health in order to encourage more mothers to embrace the continuum of care practices through home visiting and postnatal follow ups by the healthcare providers.