ASSESSMENT OF POST NATAL CARE PRACTICES BY CLINICIANS AT JARAMOGI OGINGA ODINGA TEACHING AND REFERRAL HOSPITAL IN KISUMU KENYA
Odeny, Ephraim Kayi
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The major complications that account for nearly 75% of all maternal deaths worldwide occur during the post natal period. Clinician practices of post natal care have not been adequately studied to determine to what extent these practices contribute to post natal morbidity and mortality. This study looked at the clinician post natal care practices at Jaramogi Oginga Odinga Teaching and Referral Hospital, a level 5 facility in Kenya Kisumu County serving the larger Western Kenya Region. This was a descriptive study. A total of 47 clinicians including Doctors, Nurses and Clinical Officers were sampled by conveniencee sampling. Post natal mothers were sampled through simple random sampling. The sampled mothers’ files were checked for documented care by clinicians and a checklist developed to record the documented post natal care practices by the clinicians. Questionnaires for clinicians and mothers were developed based on the WHO, MOPHs and MOMS guidelines on post natal care. Questionnaires were administered by research assistants and data was analyzed using Microsoft excel. Results indicate that Pulse rate was the most frequently assessed and documented by clinicians at 90.1% (200), followed by blood pressure at 88.7% (197). The least assessed was psychological state of the post natal mother at 5.4% (12). Most of the post natal mothers were discharged on prophylactic antibiotic 97.7% (217) and folic acid and iron supplementation 96.8% (215) and 88.3% (196) had their HIV status documented. There was very low documentation of counseling to the mother at 59% (13). Post natal mothers reported very low percentage of care especially education on danger signs: heavy vaginal bleeding 49.5%, anemia 31.5% and engorged breast 28.4%. Despite the low level of PNC health messages provided to them, they feel that they are adequately prepared to handle complications at home 98.1%. This is a major area of concern regarding the safety of post natal mother at home and decision making to return to facility for further care.