Knowledge of intrapartum care among obstetric care providers in rural Kenya

Int Health. 2019 Jul 1;11(4):258-264. doi: 10.1093/inthealth/ihy078.


Background: Kenya did not meet its maternal mortality ratio (MMR) target under the Millennium Development Goals. The aim of this study was to examine the gaps in knowledge of intrapartum care among obstetric care providers (OCPs) in rural Nandi County, Kenya.

Methods: This cross-sectional study in 2015 surveyed 326 nurses, midwives, clinical officers and physicians about their knowledge, attitudes and practices related to normal labor and childbirth, immediate newborn care and management of obstetric complications.

Results: Self-reported intrapartum knowledge among OCPs was insufficient according to accepted international standards. The mean total knowledge score for all OCPs based on a validated 30-question inventory was 62% (range 23-90%). Only 14 providers (4%) scored as 'competent' (a score ≥80%). Scores were higher for OCPs who had received pre- and postemployment emergency obstetric care training and those with higher levels of confidence in their skills. Survey respondents identified a lack of knowledge as one of the greatest barriers to high-quality patient care.

Conclusions: Increasing training opportunities for OCPs may improve the quality of obstetric care provided to women in Kenya and other high-MMR locations in sub-Saharan Africa and enable progress toward achieving the ambitious Sustainable Development Goals target for maternal survival.

Keywords: Africa; childbirth; clinical competence; maternal mortality; midwifery; obstetrics.

MeSH terms

  • Adult
  • Aged
  • Clinical Competence*
  • Cross-Sectional Studies
  • Delivery, Obstetric*
  • Emergency Medical Services
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant, Newborn
  • Kenya
  • Male
  • Maternal Death / prevention & control
  • Maternal Mortality
  • Middle Aged
  • Midwifery
  • Nurses / standards*
  • Perinatal Care / standards*
  • Physicians / standards*
  • Pregnancy
  • Pregnancy Complications
  • Quality of Health Care
  • Rural Population*
  • Surveys and Questionnaires