Management Practices of Nurses on Reproductive Health Services for Persons Living with Disabilities in Thika Hospital, Kenya

Abstract

Globally, persons living with disabilities experience myriad of challenges associated with reproductive health and face new vulnerabilities to human rights abuses at the onset of adolescence. Though the health system that manages overall health issues under the Ministry of Health in Kenya include the general reproductive health services to all population segments, persons with disabilities have limited or no access to education and health, among other issues whose impact especially on reproductive health has been exposure to unwanted early pregnancies, unsafe abortions and sexually transmitted infections including HIV. Objective: The main objective of this study was to determine the management practices of nurses of nurses on reproductive health services of persons with disabilities in Thika Level 5 hospital. Method: The study was conducted in Thika level 5 hospital and it adopted a descriptive cross-sectional design where both quantitative and qualitative techniques in data collection were utilized. The study population comprised of nurses working at the hospital and persons living with disabilities. Systematic and purposive sampling methods were used to get the sample size required for the study. Pretesting was done to ensure validity and reliability. Data was collected using self-administered structured questionnaire, key informant interviews and focus group discussions. Data entry and analysis from questionnaire was done using STATA. Descriptive statistics were used to describe variability and dispersion of responses, Likert scale used to measure the attitude of Nurses and results presented in tables, charts, graphs and narratives. Data from key informant interviews and focused group discussion were transcribed and subjected to content and thematic analytical processes that ranged from coding to categorization of themes which were developed from the responses in line with the study objectives. Its findings were presented in narrative and verbatim form. Ethical approval was sought and granted from KNH/UON ethical review committee. Informed consent was obtained individually from respondents prior to their acceptance to participate in the study. Results: The study found out that all RHS are available to PLDs like any other person in the society though they face a number of challenges associated with management of these services. This include lack of policies (45%), inaccessibility (36.4%), stigma (23.2%), affordability (14.6%). The attitude of Nurses had significant influence towards RHS for PLDs. Conclusion: PLDs will continue to face direct health-related consequences such as unplanned, unintended pregnancies, poor health and STIs, among others, and the impact of the same, if the identified challenges associated with the management and provision of RHS are not adequately addressed. Clarity on how RHS needs to be provided to PLDs is greatly missing from the management. The Ministry of Health should embrace feasible strategies of embracing a robust health system in Kenya and Kiambu county to ensure that it’s sensitive and responsive to the main challenges and the needs of PLDs in regards to RHS.