Antenatal and delivery care in rural western Kenya: the effect of training health care workers to provide focused antenatal careReport as inadecuate

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Reproductive Health

, 7:1

First Online: 29 April 2010Received: 04 June 2009Accepted: 29 April 2010DOI: 10.1186-1742-4755-7-1

Cite this article as: Ouma, P.O., van Eijk, A.M., Hamel, M.J. et al. Reprod Health 2010 7: 1. doi:10.1186-1742-4755-7-1


BackgroundMaternal mortality remains high in developing countries and data to monitor indicators of progress in maternal care is needed. We examined the status of maternal care before and after health care worker HCW training in WHO recommended Focused Antenatal Care.

MethodsAn initial cross-sectional survey was conducted in 2002 in Asembo and Gem in western Kenya among a representative sample of women with a recent birth. HCW training was performed in 2003 in Asembo, and a repeat survey was conducted in 2005 in both areas.

ResultsAntenatal clinic ANC attendance was similar in both areas 86% in 2005 and not significantly different from 2002 90%. There was no difference in place of delivery between the areas or over time. However, in 2005, more women in Asembo were delivered by a skilled assistant compared to Gem 30% vs.23%, P = 0.04, and this proportion increased compared to 2002 17.6% and 16.1%, respectively. Provision of iron 82.4%, folic acid 72.0%, sulfadoxine-pyrimethamine 61.7%, and anthelminths 12.7% had increased in Asembo compared to 2002 2002: 53.3%, 52.8%, 20.3%, and 4.6%, respectively, and was significantly higher than in Gem in 2005 Gem 2005: 69.7%, 47.8%, 19.8%, and 4.1%, respectively P < 0.05 for all. Offering of tests for sexually transmitted diseases and providing information related to maternal health was overall low <20% and did not differ by area. In 2005, more women rated the quality of the antenatal service in Asembo as very satisfactory compared to Gem 17% vs. 6.5%, P < 0.05.

ConclusionsWe observed improvements in some ANC services in the area where HCWs were trained. However, since our evaluation was carried out 2 years after three-day training, we consider any significant, sustained improvement to be remarkable.

Electronic supplementary materialThe online version of this article doi:10.1186-1742-4755-7-1 contains supplementary material, which is available to authorized users.

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Author: Peter O Ouma - Anna M van Eijk - Mary J Hamel - Evallyne S Sikuku - Frank O Odhiambo - Kaendi M Munguti - John G Ayi


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