EFFECTS OF EMERGENCY OBSTETRICS AND NEONATAL CARE TRAINING ON MATERNAL AND PERINATAL OUTCOMES: KAKAMEGA COUNTY, KENYA.

Abstract

Background: Globally, perinatal mortality rate is 19 deaths per1000 births and maternal mortality is 240 per100, 000 live births. In Africa maternal mortality rate is 500 per100, 000 live births and perinatal mortality is 49 per 1000 births. In Kenya complications related to pregnancy and child birth are the leading causes of maternal mortality translating to 488 per 100,000 live births. In Kakamega District, Maternal mortality rate was 880 per 100,000 live births while perinatal mortality rate was 77 per 1000 pregnancies. Objective: The main objective of the study was to determine the effect of emergency obstetrics and neonatal care training on maternal and perinatal outcomes in Kakamega County. Methods: A descriptive cross sectional and retrospective research design was adopted. The target population comprised of frontline healthcare workers trained in EmONC in the 32 health facilities within the county. Purposive sampling technique was used to select 325 respondents. Data was collected using questionnaire, document analysis, observation, and interview and Focus Group discussion. Data was analyzed using descriptive and inferential statistics using Statistical Package for Social Sciences version 21.The finding of this study showed that knowledge and skills of healthcare providers on monitoring a woman in labour improved significantly after the training (p<0.05). The healthcare providers’ knowledge and skills on neonatal care improved as depicted by a Chi-square (p<0.05). Maternal and perinatal mortality rate reduced from 627 in county general hospital, 333 in county hospitals, 458 in sub county hospitals and 80 in health centres in the year 2010 before training to 285 in county general hospital, 48 in county hospitals, 41 in sub county hospitals and there were no maternal deaths in health centres in the year 2015 after the training. However, the healthcare staff experience challenges during EmONC service delivery which include; inadequate staff, inadequate equipments and supplies, inadequate stock of key drugs and consumables and insufficient transport and communication. Conclusion: the County government should address the challenges that interfere with the implementation of EmONC services.