Knowledge and skills of nurse-midwives in basic newborn resuscitation at Elgeyo-Marakwet County Hospitals-Kenya

Abstract

Introduction: Majority of neonatal deaths could be prevented with proper pre-natal; intrapartum care and training of midwives on neonatal resuscitation techniques which help reduce early neonatal deaths. Elgeyo-Marakwet County has a neonatal mortality rate of 62/1000 live births which is higher than the national mortality rate of 20/1000 live births. One of the major causes of neonatal deaths is birth asphyxia Objective: To determine the knowledge and skills of basic neonatal resuscitation among nurse midwives and to determine the factors associated with their knowledge and skills on newborn resuscitation at Elgeyo-Marakwet County Hospitals. Study methods: A cross-sectional study design carried out at 9 health care facilities in Elgeyo-Marakwet County. A sample of 78 out of 94 nurse-midwives was selected usingconveniencesamplingtechnique.Datawascollectedusingbothstructuredquestionnai res and two Observation Checklists based on the Help Baby breathe tool. The questionnaire was self-administered by the nurse midwives, whereas the performance on skills was used on mannequin using two scenarios. Data was analyzed using SPSS Version 21. Descriptive statistics were used for continuous variables while categorical variables were presented in graphs and tables. Chi square and Fishers Exact were used to test for association between categorical variables. A p-value of <0.05 at95% confidence interval was considered significant. Results: Majority of participants (60) 77% were diploma holders, graduates were (2)3%. Only (44) 56% received in-service training on newborn resuscitation. Performance on knowledge score indicated that only 14% were knowledgeable (>80%) using HBB standards. Average Skills on baby born through meconium was 76% and Baby born and does not cry when cord is cut score 85%. Performance on skills gave an average of scored 80%. The skill that was performed best was looking into the baby mouth at 96%.Chi square and Fishers were used to test for association between the characteristics of the nurse-midwives‟ knowledge and performance of skills. There was significance difference between in-service training and newborn resuscitation p=0.002 and also between knowledge verses supervision at p=0.005. Conclusion: The study shows, Nurse-midwives in Elgeyo-Marakwet County do not have adequate level of knowledge and clinical skills performance on basic newborn resuscitation. Nurse-midwives have deficient performance on clinical skills on newborn resuscitation. There was positive association between in service training and newborn resuscitation. Recommendations: There is need for refresher course trainings and more frequent re-assessment on knowledge. Skills improvement for the nurse-midwives to be conducted through on-going clinical practice, Continuous Medical Education and monitoring to acceptable standards. Supportive supervision is needed to mentor nursemidwives on clinical skills and knowledge.