Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.

<h4>Introduction</h4>Peri-urban settings have high maternal mortality and the quality of care received in different types of health facilities is varied. Yet few studies have explored the construct of person-centered maternity care (PCMC) within peri-urban settings. Understanding women&#...

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Main Authors: Jackline Oluoch-Aridi, Patience Afulani, Cindy Makanga, Danice Guzman, Laura Miller-Graff
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0257542
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author Jackline Oluoch-Aridi
Patience Afulani
Cindy Makanga
Danice Guzman
Laura Miller-Graff
author_facet Jackline Oluoch-Aridi
Patience Afulani
Cindy Makanga
Danice Guzman
Laura Miller-Graff
author_sort Jackline Oluoch-Aridi
collection DOAJ
description <h4>Introduction</h4>Peri-urban settings have high maternal mortality and the quality of care received in different types of health facilities is varied. Yet few studies have explored the construct of person-centered maternity care (PCMC) within peri-urban settings. Understanding women's experience of maternity care in peri-urban settings will allow health facility managers and policy makers to improve services in these settings. This study examines factors associated with PCMC in a peri-urban setting in Kenya.<h4>Methods and materials</h4>We analyzed data from a cross-sectional study with 307 women aged 18-49 years who had delivered a baby within the preceding six weeks. Women were recruited from public (n = 118), private (n = 76), and faith based (n = 113) health facilities. We measured PCMC using the 30-item validated PCMC scale which evaluates women's experiences of dignified and respectful care, supportive care, and communication and autonomy. Factors associated with PCMC were evaluated using multilevel models, with women nested within facilities.<h4>Results</h4>The average PCMC score was 58.2 (SD = 13.66) out of 90. Controlling for other factors, literate women had, on average, about 6-point higher PCMC scores than women who were not literate (β = 5.758, p = 0.006). Women whose first antenatal care (ANC) visit was in the second (β = -5.030, p = 0.006) and third trimester (β = -7.288, p = 0.003) had lower PCMC scores than those whose first ANC were in the first trimester. Women who were assisted by an unskilled attendant or an auxiliary nurse/midwife at birth had lower PCMC than those assisted by a nurse, midwife or clinical officer (β = -8.962, p = 0.016). Women who were interviewed by phone (β = -7.535, p = 0.006) had lower PCMC scores than those interviewed in person.<h4>Conclusions</h4>Factors associated with PCMC include literacy, ANC timing and duration, and delivery provider. There is a need to improve PCMC in these settings as part of broader quality improvement activities to improve maternal and neonatal health.
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spelling doaj.art-35a4b6e57fad42e3a5cab644517aa9d32022-12-21T19:08:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011610e025754210.1371/journal.pone.0257542Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.Jackline Oluoch-AridiPatience AfulaniCindy MakangaDanice GuzmanLaura Miller-Graff<h4>Introduction</h4>Peri-urban settings have high maternal mortality and the quality of care received in different types of health facilities is varied. Yet few studies have explored the construct of person-centered maternity care (PCMC) within peri-urban settings. Understanding women's experience of maternity care in peri-urban settings will allow health facility managers and policy makers to improve services in these settings. This study examines factors associated with PCMC in a peri-urban setting in Kenya.<h4>Methods and materials</h4>We analyzed data from a cross-sectional study with 307 women aged 18-49 years who had delivered a baby within the preceding six weeks. Women were recruited from public (n = 118), private (n = 76), and faith based (n = 113) health facilities. We measured PCMC using the 30-item validated PCMC scale which evaluates women's experiences of dignified and respectful care, supportive care, and communication and autonomy. Factors associated with PCMC were evaluated using multilevel models, with women nested within facilities.<h4>Results</h4>The average PCMC score was 58.2 (SD = 13.66) out of 90. Controlling for other factors, literate women had, on average, about 6-point higher PCMC scores than women who were not literate (β = 5.758, p = 0.006). Women whose first antenatal care (ANC) visit was in the second (β = -5.030, p = 0.006) and third trimester (β = -7.288, p = 0.003) had lower PCMC scores than those whose first ANC were in the first trimester. Women who were assisted by an unskilled attendant or an auxiliary nurse/midwife at birth had lower PCMC than those assisted by a nurse, midwife or clinical officer (β = -8.962, p = 0.016). Women who were interviewed by phone (β = -7.535, p = 0.006) had lower PCMC scores than those interviewed in person.<h4>Conclusions</h4>Factors associated with PCMC include literacy, ANC timing and duration, and delivery provider. There is a need to improve PCMC in these settings as part of broader quality improvement activities to improve maternal and neonatal health.https://doi.org/10.1371/journal.pone.0257542
spellingShingle Jackline Oluoch-Aridi
Patience Afulani
Cindy Makanga
Danice Guzman
Laura Miller-Graff
Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.
PLoS ONE
title Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.
title_full Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.
title_fullStr Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.
title_full_unstemmed Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.
title_short Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya.
title_sort examining person centered maternity care in a peri urban setting in embakasi nairobi kenya
url https://doi.org/10.1371/journal.pone.0257542
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