Download presentation
Presentation is loading. Please wait.
Published byDarcy Haynes Modified over 8 years ago
1
Felarmine Muiruri Dr. Joachim Osur Prof. Okello Agina
2
Kenya is 11 th country with the highest maternal mortality worldwide. (WHO, 2010). MMR was 414 in 2003 and 488 in 2008 (KDHS). More than a third of obstetric deaths are due to bleeding (Shakur et al., 2010). The majority of these deaths occur within 4 hours of delivery. (Leduc at el., 2009) AMTSL decrease PPH by 66%. (Khan et al., 2006). Practice of AMTSL recommended by FIGO, ICM, WHO & DRH to prevent PPH.
3
In Kiambu county 6 women die per month on average. (Districts quarterly reports,2011) Information gap on implementation of AMTSL and factors necessary for the implementation. 73% of women deliver in health facilities. AMTSL components Administration of oxytocin Controlled cord traction Immediate uterine massage Subsequent uterine massage
4
Broad : To assess the determinants of utilization of AMTSL by birth attendants in Kiambu County Specific: To establish AMTSL utilization status in Kiambu County. To determine the health facility factors that influence utilization of AMTSL in Kiambu County. To determine the birth attendant factors that influence utilization of AMTSL in Kiambu County.
6
Study design: Cross-sectional study. Study population:431 Birth attendants working in maternity units in 52 maternity units. Area of study: Kiambu county maternity units. Sample Size:203 calculated using Fisher et al. formula Methodology
7
Sampling method: Multistage 1 st – Stratification by type and level of facilities 2 nd –Clustering by specific health facilities Data collection tools: Questionnaires and observation check lists. Data analysis: STATA version 11 software. Chi square, Fisher’s exact and logistic regression. Confidence level 95%. Methodology Cont…
9
VariableCategoryFrequencyPercent SexFemale16681.8 Male3718.2 Age in years21-306532.0 31-407135.0 41-505125.1 51-60167.9 ProfessionNurse/midwife18892.6 Clinical officer157.4 Level of education Certificate5627.6 Diploma14069 Degree73.4
10
Tanzania (7%) and Ethiopia (4.5%) (Stanton C., at el.,2009)
13
OR =0.502 p=0.006 LR (OR 0.502 P= 0.006)
14
χ² ( P<0.001) LR (OR=5.241 P<0.001)
15
(χ² ( P<0.001) LR (OR= 7.799 P=<0.001) Availability of a fridge
16
χ² (P<0.001) LR(OR=3.037, P<0.001)
17
Availability standards documents/ level Govt L3 (n=70) Govt L4 (n=53) FBO L3 (n=21) FBO L4 (n=34) PRV L3 (n=17) PRV L4 (n=8) Available 7.1%17.0%9.5%5.9%0.0% Not available 92.9%83.0%90.5%94.1%100.0%100%
18
(Fisher’s exact 0.040). LR (P=0.062)
19
LR(P =0.893)
20
Training/ Type of Training UtilizedDid not utilizeStatistical values Trained(n=120)44.2%55.8%Fisher’s exact 0.001 LR (OR=5.178, P<0.001) Not trained (n=83)13.2%86.8% In-service(n=92)39.1%60.9%χ² (P=0.044) LR (OR=2.404 P=0.047,) Pre-service (n=28)60.7%39.3%
23
Knowledge of AMTSL UtilizedNot utilizedStatistical values Knew (n=57)56.1%43.9%χ²( P<0.001) LR (OR=4.56, P<0.001) Did know(n=146) 21.9%78.1% Total31.5%68.5%
26
Most of the birth attendants in Kiambu county do not utilize AMTSL. There is discrepancy in utilization of AMTSL among birth attendants working in different facility levels and types. Availability of AMTSL guidelines, Pre-service training and knowledge of AMTSL components have positive influence on utilization of AMTSL.
27
The county government should put strategies to increase utilization of AMTSL in level three and private facilities. Heads of facilities should ensure AMTSL standards documents are available in labour ward. Stakeholders in health training should structure In-service training of birth attendants on AMTSL
28
Thank you!
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.