FACTORS INFLUENCING ADHERENCE TO NATIONAL GUIDELINES ON EMERGENCY OBSTETRIC CARE AND ASSOCIATED HEALTH OUTCOMES A MONG PREGNANT WOMEN AND NEWBORNS IN SAMBURU CENTRAL SUB-COUNTY, KENYA

Abstract

Globally, about 830 women die daily due to complications of pregnancy and child birth. Out of these, 550 deaths occurred in sub-Saharan Africa and 180 in Southern Asia, compared to 5 in developed countries. World Health Organization recommended that all pregnant women should have access to good quality Emergency obstetric care (EMOC).The objective of the study was to establish factors influencing adherence to national guidelines on emergency obstetric care and associated health outcomes among pregnant women and newborns in Samberg Central Sub- county. The study adopted a descriptive cross-sectional design involving six public health facilities offering maternity services were involved in this study. The study was conducted between June to November 2016. A census of 990 pregnant women who had utilized the selected health facilities were involved in the study. Achecklist was also used to inspect the infrastructure in the maternity department. In addition, In addition, key-informant interviews were conducted among facility in-charges. Data was extracted into an SPSS database. Descriptive statistics and chi-square statistics were useful for analysis. Quantitative and Qualitative data were thematically coded and evaluated. The results indicated that 67.8% of the pregnant women who attended the facilities were married, 20.1% were single, and 1.6% and 8.5% were separated. On educational background 47.2% of all the pregnant women have never attended at any level of education, 24.3% primary school, 17.8% secondary school, 7% college level and 3.7% attended the university. Out of 6 health facilities five health facilities were Basic emergency obstetric cares (83.3%) offering the six signal functions while 16.7% offered comprehensive emergency obstetric care services. On EMOC training, Marital county referral hospital had 1(62.5%) trained on EMOC, SurgutMar marhealth Centre 3 (12.5%) Kisimahealth Centre (12.5%) Loosuk health Centre 1(4.7%), Porrohealth Centre1 (4.7%) and Lolmolog health Centre (4.7%). The main health outcomes encountered were obstructed labour 6(0.6%), antepartum haemorrhage (0.4%) and postpartum hemorrhage (0.4%).There was need to upgrade the at least two health facilities to provide comprehensive emergency obstetric care services. The national and county government should employ skilled health personnel and capacity building with training and knowledge and finally there was need for education of all pregnant mothers to attend antenatal clinic.