Facility Factors Influencing Utilization of Active Management of Third Stage Of Labour among Skilled Birth Attendants in Kiambu County, Kenya
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Date
2016-11-26
Authors
Felarmine, Muiruri
Joachim, Osur
Agina, Okello
Journal Title
Journal ISSN
Volume Title
Publisher
Supplement article
Abstract
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
Description
A Research Article in the Pan African Medical Journal
Keywords
Maternal mortality, Health facility factors, Skilled birth attendants, AMTSL, Active Management of Third Stage of Labor, Post-Partum Hemorrhage
Citation
Felarmine, M., Joachim, O., & Agina, O. (2016). Facility factors influencing utilization of active management of third stage of labour among skilled birth attendants in Kiambu county, Kenya. The Pan African Medical Journal, 25(Suppl 2).