Assessment of postnatal care services provided to mothers and neonates upon discharge: Mother’s perspective at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: In Africa, at least 125,000 women and 870,000 neonates die in the first week after birth annually yet this period receives less attention from health care providers. Care provided to both the mother and the neonate after birth is critical for their survival. Objectives: To assess postnatal care services provided to mothers and neonates upon discharge: Mother‘s perspective at Moi Teaching and Referral Hospital Methods: Used cross-sectional descriptive method involving mixed method approach. 270 postnatal mothers were sampled. Used researcher-administered questionnaires to collect data and analyzed using descriptive statistics via SPSS V20.Qualitative data from the open-ended questions was separately analyzed and consolidated into emerging key themes. Exact test was used to determine significant association. Results: A total of 270 respondents with a median (IQR) age of 24(21, 28) years completed the questionnaires Most 255(94.4%) of the mothers had their uterus massaged, 226(83.7%) were assessed for severe bleeding, 211(78.1%) assessed for uterine involution and 61(2.6%) assessed for breast feeding difficulties. Majority 246(91.4%) of the mothers initiated breastfeeding within one hour of birth. Most known maternal danger signs were heavy vaginal bleeding 142(52.8%), severe headache 108(40.1%), and fever 103(38.3%). Most mothers had no pulse 210(77.8%), respiration 223(82.6%) and 195(72.2%) temperature monitored. Only 25(28.1%) of mothers got antibiotics for episiotomy/tear. Mothers received information mostly on; hand washing 169(62.6%), perineal care 174(64.4%) and personal hygiene 169(62.9%). Only 83(31.2%) neonates received vitamin K and BCG 15(5.7%). Half134(49.6%) of the mothers were told to keep the umbilical cord clean and dry with majority 189(70.3%) not told when to bath their babies. Newborn danger signs mentioned mostly were; baby not breastfeeding 136(50.4%), vomiting everything 127(47%), fever 128(47.4%) and hypothermia 118(43.9%). Almost all (99.9%) mothers did not expect any others services. Significant associated was seen between unmarried mothers and support for positioning and attachment during breastfeeding, p =0.028. Conclusion: Although53% of Mothers and 41% neonates receive postnatal care services before discharge, most services provided do not conform to WHO recommendation. There is lack of maternal knowledge and awareness on postnatal care services provided to both the mother and the neonate before discharge Recommendation: Postnatal care services should be provided as recommended by WHO. Targeted health education should be provided to clients on available postnatal care services during perinatal visits to create awareness and increase maternal knowledge.