Thesis:

Factors influencing utilization of ministry of health guideline on management of preeclampsia and eclampsia at public health facilities in Migori county, Kenya

Preeclampsia and eclampsia contribute to 9 to 26 percent of maternal deaths globally. In Kenya preeclampsia and eclampsia is the second direct cause of maternal mortality. The main objective of this study was to ascertain factors influencing utilization of Ministry of Health guideline among nurses in the prevention and management of preeclampsia and eclampsia in public health facilities Migori county, Kenya. The study was guided by the following specific objectives: to determine the level of adherence of Ministry of health guideline in the management preeclampsia and eclampsia among the nurses working in public health facilities Migori County, Kenya ,to Identify the nurse related factors that influence the utilization of the Ministry of Health guideline among nurses working in public health facilities in Migori County Kenya and identify the health facility related factors that influence the utilization of the Ministry of Health guideline among nurses working in public health facilities Migori county, Kenya . The study area was Migori County targeting 7 public health facilities drawn from each Sub County in Migori county of Kenya. With regards to methodology, the study adopted the use of a descriptive cross -sectional research design and the Cochran (1977) formula was used to calculate the sample size. Through random sampling 71 respondent nurses were targeted to participate in the study, drawn from maternal and child health care clinics and maternity wards from the target public health facilities. Purposive sampling technique was used in the selection of the public facilities and specifically in perusing the clients’ records. Data collection was done through a self-administered data collection tool that is the questionnaire, a check list was also used to conduct facility assessment and audit of the patients’ records, in addition, focus group discussion was done. To ensure reliability pre-testing of 10 percent of the questionnaires was done at Uriri Sub County Hospital. The data analysis was done using computer statistical package SPSS version 28 and the presentation of findings was done in form of frequency tables and charts. The findings of the study revealed that male respondents were 12(16.9%), female59(83.1%) the age of the respondents ranged between 25-58 years with the mean age of 8.4. The only socio-demographic variable that had significant value was the period one worked in a unit p(0.001). Adherence level was at 30 % with mean value of adherence of 56.7 though 97.1% of the respondents self-reported using the ministry of health guidelines for preeclampsia and eclampsia. The nurse related factors on management preeclampsia and eclampsia showed that 21(30%) of the respondents had adequate knowledge, while 50 (70%) did not have good knowledge. The comprehensive knowledge of the nurse had a significant value of p (0.000). The overall perception of the nurses on the ministry of health guideline for preeclampsia and eclampsia management was good based on its clarity and ease to follow with a statistical value p (0.005). In conclusion majority of the respondents had poor knowledge and their adherence was low towards the guideline. Most of the health facilities did not have the guideline. The recommendations for this study are that guideline should made available and displayed in maternity and maternal and child health care clinic. The frequent continuous medical education and training for nurses will enhance their knowledge and practice. Further studies to be conducted on the use of ministry of health guideline for preeclampsia and eclampsia among all the health care providers within these public health facilities.