Assessment of Structure and Process Factors Influencing Dignified Intrapartum Care Among Midwives at Kenyatta National Hospital

Abstract

Background: Dignified intrapartum care is the basic right for every woman during childbirth. Non- dignified intrapartum care has been reported globally, and recognized as a powerful deterrence to facility-based childbirth. In Kenya, undignified intrapartum care has been frequently reported. Free maternity policy and protecting the woman (Linda mama) programs in Kenya have led to increased health facility births. The surge of women seeking health facility childbirth has led to overstretching of health facilities, leading to mistreatment and abuse during labour and delivery. Objective: To assess the structural and process factors that influence dignified intrapartum care at the Kenyatta National Hospital (KNH). Methods: This study was conducted at the Kenyatta National, Hospital labour ward. The design was descriptive, cross-sectional employing a quantitative approach through a self-administered questionnaire. Ethical approval was sought from Kenyatta national hospital- University of Nairobi ethics research committee (KNH-UoN ERC). Data were collected within four weeks. The sample size was 79 midwives. A simple random sampling method was used to select the respondents. Data were collected, entered, cleaned, and analysed using SPSS version 24. Descriptive and inferential statistics were reported and presented using tables, figures, and plain text. Association between study variables was estimated using chi-square statistics at a significance level of 5% and a confidence interval of 95%. Results: Majority of respondents were aged between (24-29) years 45%., with Most of them having worked between 1-3 years at the KNH labour ward, 45.2%. Majority of the respondents, 66.7% had worked in another facility in the labour ward. The majority of respondents were diploma holders 63.5%. Conclusion: Structure factors were identified as an influence the delivery of dignified intrapartum care which fits in within the Donabedian theory, which states structure has influence quality of care delivered.