Health care providers' knowledge of clinical protocols for postpartum hemorrhage care in Kenya: a cross-sectional study.
Health care providers
Knowledge
Postpartum hemorrhage
Sub-Saharan Africa
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
10 Nov 2022
10 Nov 2022
Historique:
received:
30
06
2022
accepted:
18
10
2022
entrez:
11
11
2022
pubmed:
12
11
2022
medline:
15
11
2022
Statut:
epublish
Résumé
Postpartum hemorrhage (PPH) remains the leading cause of maternal death worldwide despite its often-preventable nature. Understanding health care providers' knowledge of clinical protocols is imperative for improving quality of care and reducing mortality. This is especially pertinent in referral and teaching hospitals that train nursing and medical students and interns in addition to managing emergency and referral cases. This study aimed to (1) measure health care providers' knowledge of clinical protocols for risk assessment, prevention, and management of PPH in 3 referral hospitals in Kenya and (2) examine factors associated with providers' knowledge. We developed a knowledge assessment tool based on past studies and clinical guidelines from the World Health Organization and the Kenyan Ministry of Health. We conducted in-person surveys with health care providers in three high-volume maternity facilities in Nairobi and western Kenya from October 2018-February 2019. We measured gaps in knowledge using a summative index and examined factors associated with knowledge (such as age, gender, qualification, experience, in-service training attendance, and a self-reported measure of peer-closeness) using linear regression. We interviewed 172 providers including consultants, medical officers, clinical officers, nurse-midwives, and students. Overall, knowledge was lowest for prevention-related protocols (an average of 0.71 out of 1.00; 95% CI 0.69-0.73) and highest for assessment-related protocols (0.81; 95% CI 0.79-0.83). Average knowledge scores did not differ significantly between qualified providers and students. Finally, we found that being a qualified nurse, having a specialization, being female, having a bachelor's degree and self-reported closer relationships with colleagues were statistically significantly associated with higher knowledge scores. We found gaps in knowledge of PPH care clinical protocols in Kenya. There is a clear need for innovations in clinical training to ensure that providers in teaching referral hospitals are prepared to prevent, assess, and manage PPH. It is possible that training interventions focused on learning by doing and teamwork may be beneficial.
Sections du résumé
BACKGROUND
BACKGROUND
Postpartum hemorrhage (PPH) remains the leading cause of maternal death worldwide despite its often-preventable nature. Understanding health care providers' knowledge of clinical protocols is imperative for improving quality of care and reducing mortality. This is especially pertinent in referral and teaching hospitals that train nursing and medical students and interns in addition to managing emergency and referral cases.
METHODS
METHODS
This study aimed to (1) measure health care providers' knowledge of clinical protocols for risk assessment, prevention, and management of PPH in 3 referral hospitals in Kenya and (2) examine factors associated with providers' knowledge. We developed a knowledge assessment tool based on past studies and clinical guidelines from the World Health Organization and the Kenyan Ministry of Health. We conducted in-person surveys with health care providers in three high-volume maternity facilities in Nairobi and western Kenya from October 2018-February 2019. We measured gaps in knowledge using a summative index and examined factors associated with knowledge (such as age, gender, qualification, experience, in-service training attendance, and a self-reported measure of peer-closeness) using linear regression.
RESULTS
RESULTS
We interviewed 172 providers including consultants, medical officers, clinical officers, nurse-midwives, and students. Overall, knowledge was lowest for prevention-related protocols (an average of 0.71 out of 1.00; 95% CI 0.69-0.73) and highest for assessment-related protocols (0.81; 95% CI 0.79-0.83). Average knowledge scores did not differ significantly between qualified providers and students. Finally, we found that being a qualified nurse, having a specialization, being female, having a bachelor's degree and self-reported closer relationships with colleagues were statistically significantly associated with higher knowledge scores.
CONCLUSION
CONCLUSIONS
We found gaps in knowledge of PPH care clinical protocols in Kenya. There is a clear need for innovations in clinical training to ensure that providers in teaching referral hospitals are prepared to prevent, assess, and manage PPH. It is possible that training interventions focused on learning by doing and teamwork may be beneficial.
Identifiants
pubmed: 36357842
doi: 10.1186/s12884-022-05128-6
pii: 10.1186/s12884-022-05128-6
pmc: PMC9647972
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
828Informations de copyright
© 2022. The Author(s).
Références
Am Psychol. 2018 May-Jun;73(4):349-362
pubmed: 29792453
BMC Pregnancy Childbirth. 2019 Dec 11;19(1):489
pubmed: 31829139
BJOG. 2015 Jan;122(2):202-10
pubmed: 25289730
Health Aff (Millwood). 2016 Sep 1;35(9):1716-24
pubmed: 27605655
Afr Health Sci. 2021 Mar;21(1):304-310
pubmed: 34394311
Int J Gynaecol Obstet. 2013 Jan;120(1):74-7
pubmed: 23182799
Int J Gynaecol Obstet. 2022 Jun;158 Suppl 1:14-22
pubmed: 35762810
J Clin Nurs. 2019 Mar;28(5-6):882-893
pubmed: 30357971
Int J Womens Health. 2013 Nov 13;5:737-52
pubmed: 24259988
Int J Health Plann Manage. 2021 Nov;36(6):2277-2296
pubmed: 34382238
Lancet. 2016 Jan 30;387(10017):462-74
pubmed: 26584737
Int J Gynaecol Obstet. 2013 Dec;123(3):254-6
pubmed: 24054054
PLoS One. 2015 Jun 24;10(6):e0129491
pubmed: 26107655
Acta Obstet Gynecol Scand. 2006;85(7):797-804
pubmed: 16817076
Trop Med Int Health. 2021 May;26(5):535-545
pubmed: 33529436
BMC Health Serv Res. 2007 Feb 07;7:17
pubmed: 17284324
BMC Pregnancy Childbirth. 2017 Sep 7;17(1):292
pubmed: 28882109
BMJ Open. 2016 Jan 22;6(1):e009734
pubmed: 26801466
BJOG. 2010 Jun;117(7):777-87
pubmed: 20406229
Biomed Res Int. 2020 Nov 03;2020:8547040
pubmed: 33204719
Ann Pediatr Cardiol. 2018 May-Aug;11(2):130-136
pubmed: 29922009
Health Policy Plan. 2019 Mar 1;34(2):120-131
pubmed: 30843068
Int J Gynaecol Obstet. 2016 Dec;135(3):268-271
pubmed: 27569024
PLoS One. 2020 Jan 7;15(1):e0214836
pubmed: 31910210
BMJ Glob Health. 2021 Jun;6(6):
pubmed: 34108145
PLoS One. 2017 Jan 31;12(1):e0171236
pubmed: 28141840