Uptake of Neonatal Vitamin K Prophylaxis in the Postnatal Wards of Kenyatta National Hospital

Abstract

Vitamin K can prevent Vitamin K deficiency bleeding in neonates which is an infrequent (4.2 to 7.8 per 100000 live births) but a dangerous condition which can cause permanent disability and has a high mortality. Vitamin K is readily available low cost, safe and easy to use. Neonates have insufficient levels of vitamin K placing them in danger of vitamin K deficiency bleeding. Current Kenyan clinical practice guideline in line with World Health Organization promotes universal vitamin K prophylactic use in neonates. Objectives To determine the proportion of neonates who receive vitamin K prophylaxis at postnatal wards in Kenyatta National Hospital and to access factors affecting uptake of vitamin K prophylaxis at postnatal wards in Kenyatta National hospital. Methodology A hospital-based descriptive cross-sectional study. Quantitative analysis was used to determine the number of neonates who receive vitamin K prophylaxis, while qualitative analysis was used to assess factors affecting the uptake of vitamin K prophylaxis in the postnatal wards of Kenyatta National Hospital. The proportion of neonates who received Vitamin K prophylaxis was analyzed as proportion and key informant interview data was analyzed thematically. Results A total of 384 neonates were enrolled. The uptake of intramuscular Vitamin K in the study was very low at 6.8% with a 95% confidence interval. (26/358). There were no clinical factors i.e., parity, induction, mode of delivery and neonate gender that were statistically associated with uptake of vitamin K. Factors affecting uptake of vitamin K in postnatal ward in KNH were inconsistence stock, stock outs, lack of awareness and sensitization, lack of a follow up strategy for accountability purposes, lack of proper formulations (available formulations included 2mg and 10mg vial but the health workers preferred the 1mg vial) and low ratio (1:10) of health worker to patient. Conclusion Although prophylactic administration of vitamin K to neonates is relatively well integrated into policy at the global and national level the uptake in Kenyatta National Hospital is very low. Barriers to vitamin K administration were supply and access to the drug, lack of awareness and documentation, inadequate number of healthcare providers and perception that vitamin K prophylactic treatment is not a priority.