Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya
Background: Continuity and coordination of care are core principles of high-quality primary health care. Optimising continuity and coordination improves maternal satisfaction. However, their association with morbidity and mortality outcomes is unclear. The obstetric near-miss approach can be used to...
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| Format: | Article |
| Language: | English |
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AOSIS
2023-01-01
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| Series: | African Journal of Primary Health Care & Family Medicine |
| Subjects: | |
| Online Access: | https://phcfm.org/index.php/phcfm/article/view/3452 |
| _version_ | 1797937216295534592 |
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| author | Samuel M. Mulongo Doreen Kaura Bob Mash |
| author_facet | Samuel M. Mulongo Doreen Kaura Bob Mash |
| author_sort | Samuel M. Mulongo |
| collection | DOAJ |
| description | Background: Continuity and coordination of care are core principles of high-quality primary health care. Optimising continuity and coordination improves maternal satisfaction. However, their association with morbidity and mortality outcomes is unclear. The obstetric near-miss approach can be used to investigate whether continuity and coordination influences the occurrence of a severe maternal outcome.
Aim: To compare self-reported continuity and coordination of care between obstetric near-miss survivors and those without near miss during pregnancy, delivery and postpartum.
Setting: Uasin Gishu county, Rift Valley region, Kenya.
Methods: A cross-sectional survey targeting 340 postnatal mothers. Continuity of care index (COCI) and modified continuity of care index (MCCI) were used to estimate longitudinal continuity. The Likert scale was administered to measure perceived continuity and coordination of care. Mann–Whitney U test and binomial logistic regression were used for hypothesis testing.
Results: COCI and MCCI were lower among near-miss survivors (COCI = 0.80, p = 0.0026), (MCCI = 0.62, p = 0.034). Near-miss survivors scored lower on items assessing coordination between a higher-level provider and usual antenatal clinic (mean = 3.6, p = 0.006) and general coordination of care during pregnancy (mean = 3.9, p = 0.019). Presence of a non-life-threatening morbidity in pregnancy was associated with occurrence of near miss (aOR = 4.34, p = 0.001).
Conclusion: Near-miss survivors scored lower on longitudinal continuity and coordination of care across levels. Further research should focus on strengthening coordination, determining the optimal level of longitudinal continuity and improving systems for early identification and management of morbidities in pregnancy.
Contribution: The results of this study show that while longitudinal and relational COC is important during the antenatal period, the presence of a non-life-threatening condition in pregnancy remains the most important predictor of the occurrence of a near miss. |
| first_indexed | 2024-04-10T18:42:16Z |
| format | Article |
| id | doaj.art-e349c2899e71422d8cfe59297aca39aa |
| institution | Directory Open Access Journal |
| issn | 2071-2928 2071-2936 |
| language | English |
| last_indexed | 2024-04-10T18:42:16Z |
| publishDate | 2023-01-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Primary Health Care & Family Medicine |
| spelling | doaj.art-e349c2899e71422d8cfe59297aca39aa2023-02-01T13:05:37ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362023-01-01151e1e810.4102/phcfm.v15i1.34521007Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, KenyaSamuel M. Mulongo0Doreen Kaura1Bob Mash2Department of Nursing, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownDepartment of Nursing, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownDepartment of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownBackground: Continuity and coordination of care are core principles of high-quality primary health care. Optimising continuity and coordination improves maternal satisfaction. However, their association with morbidity and mortality outcomes is unclear. The obstetric near-miss approach can be used to investigate whether continuity and coordination influences the occurrence of a severe maternal outcome. Aim: To compare self-reported continuity and coordination of care between obstetric near-miss survivors and those without near miss during pregnancy, delivery and postpartum. Setting: Uasin Gishu county, Rift Valley region, Kenya. Methods: A cross-sectional survey targeting 340 postnatal mothers. Continuity of care index (COCI) and modified continuity of care index (MCCI) were used to estimate longitudinal continuity. The Likert scale was administered to measure perceived continuity and coordination of care. Mann–Whitney U test and binomial logistic regression were used for hypothesis testing. Results: COCI and MCCI were lower among near-miss survivors (COCI = 0.80, p = 0.0026), (MCCI = 0.62, p = 0.034). Near-miss survivors scored lower on items assessing coordination between a higher-level provider and usual antenatal clinic (mean = 3.6, p = 0.006) and general coordination of care during pregnancy (mean = 3.9, p = 0.019). Presence of a non-life-threatening morbidity in pregnancy was associated with occurrence of near miss (aOR = 4.34, p = 0.001). Conclusion: Near-miss survivors scored lower on longitudinal continuity and coordination of care across levels. Further research should focus on strengthening coordination, determining the optimal level of longitudinal continuity and improving systems for early identification and management of morbidities in pregnancy. Contribution: The results of this study show that while longitudinal and relational COC is important during the antenatal period, the presence of a non-life-threatening condition in pregnancy remains the most important predictor of the occurrence of a near miss.https://phcfm.org/index.php/phcfm/article/view/3452longitudinal continuityrelational continuityparallel coordinationsequential coordinationobstetric near miss. |
| spellingShingle | Samuel M. Mulongo Doreen Kaura Bob Mash Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya African Journal of Primary Health Care & Family Medicine longitudinal continuity relational continuity parallel coordination sequential coordination obstetric near miss. |
| title | Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya |
| title_full | Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya |
| title_fullStr | Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya |
| title_full_unstemmed | Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya |
| title_short | Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya |
| title_sort | self reported continuity and coordination of antenatal care and its association with obstetric near miss in uasin gishu county kenya |
| topic | longitudinal continuity relational continuity parallel coordination sequential coordination obstetric near miss. |
| url | https://phcfm.org/index.php/phcfm/article/view/3452 |
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