Evaluation of Large-Scale Implementation of Obstetric Point of Care Ultrasound in Eight Counties in Kenya Using RE-AIM Framework

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dc.contributor.authorGithemo,Grace
dc.contributor.authorWanyoro,Anthony
dc.contributor.authorMasika,Jacob
dc.contributor.authorOnsongo,Lister
dc.contributor.authorBett,Sarah
dc.contributor.authorGithuku,Stephen
dc.contributor.authorGachuiri,Grace
dc.contributor.authorWalker,Dilys
dc.contributor.authorSantos, Nicole
dc.contributor.authorGhosh,Rakesh
dc.contributor.authorOtieno,George
dc.date.accessioned2025-09-24T06:31:55Z
dc.date.available2025-09-24T06:31:55Z
dc.date.issued2025-08
dc.descriptionresearch article
dc.description.abstractAbstract Background Obstetric Point-of-Care Ultrasound (O-POCUS) holds promise for strengthening maternal health services particularly in low- and middle-income countries (LMICs). However, its widespread use is hindered by limited provider training and resource constraints within health facilities. To address this gap, a large-scale O-POCUS program was implemented across eight counties of Kenya whereby 468 healthcare providers (HCPs) from 224 facilities were trained in five basic O-POCUS parameters. This study evaluated the reach, effectiveness, adoption, implementation, and maintenance of this program using the RE-AIM framework. Methods For this cross-sectional evaluation study, trained research staff conducted surveys and in-depth interviews with HCPs, stakeholders, and antenatal and postnatal care clients for one week from a random sample of about half of these facilities (n=114) six months after O-POCUS introduction. A total of 249 HCPs, 2,292 antenatal and 1,704 postnatal clients were surveyed, and 96 HCPs/stakeholders and 114 clients were interviewed. Data were analyzed using descriptive and thematic methods and mapped onto the RE-AIM framework to assess program implementation. Results The findings revealed that O-POCUS was implemented across all 114 health facilities and 1937 (49%) of surveyed clients received a scan (reach). Over 80% of trained HCPs reported moderate to high confidence in performing key obstetric assessments, and 72% reported that O-POCUS influenced clinical decision-making including referrals (effectiveness). 41% of HCPs conducted more than 20 scans per month and 89% of the clients reported that they were likely to recommend O-POCUS to others (adoption). Lack of resources such as gel and paper towels were identified as major challenges (implementation), while 60% of HCPs reported the need for further training and mentorship (maintenance). Conclusion These findings demonstrate successful large-scale implementation of O-POCUS in Kenya and provide valuable insights for policymakers and healthcare organizations seeking to implement similar O-POCUS programs in resource-limited settings. Continuous strengthening through mentorship, supportive supervision and resource provision is recommended for sustained success of O-POCUS in improving maternal healthcare.
dc.identifier.citationGithemo, Grace, et al. "Evaluation of large-scale implementation of obstetric point of care ultrasound in eight counties in Kenya using RE-AIM framework." BMC Health Services Research 25.1 (2025): 1016.
dc.identifier.urihttps://doi.org/10.1186/s12913-025-13212-8
dc.identifier.urihttps://ir-library.ku.ac.ke/handle/123456789/31448
dc.language.isoen
dc.publisherSpringer Nature
dc.titleEvaluation of Large-Scale Implementation of Obstetric Point of Care Ultrasound in Eight Counties in Kenya Using RE-AIM Framework
dc.typeArticle
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