TITLE:
Knowledge and Skills Gap of Midwives to Conduct Obstetric Ultrasonography Screening in Primary Health Care Facilities in Kajiado and Kisii Counties, Kenya
AUTHORS:
Micah Matiang’i, Priscilla Ngunju, Josephat Nyagero, Jarim Omogi
KEYWORDS:
Antenatal Care, Basic Ultrasound Screening, Midwives, Primary Health Care
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.10 No.2,
June
30,
2020
ABSTRACT: Background: Ultrasound remains a tool of much importance in
maternity care with midwives regarded as key health professionals when it comes
to care of pregnant mothers. There is however limited study on the knowledge
and skills gaps of midwives in conducting obstetric ultrasonography screening.
The purpose of this study was to assess the specific obstetric ultrasonography
knowledge and skills gaps among midwives based in primary health care facilities. Methods: A cross-sectional study employing both qualitative and quantitative
method was conducted between July and August 2019 with 274 midwives. A
structured questionnaire was used to collect data while Focus group discussion
and Key Informants Interview were used to collect qualitative data. Descriptive
statistics were used to summarize the data test associations between variables
while the qualitative data were used to compliment the questionnaire data in
eliciting more information on the gaps. Findings: Almost all (94.5%) the
midwives had never been trained on any basic obstetric ultrasound while six of
those that had been trained in early stages by the project lacked equipment
to practice the acquired skills. More than three quarters of the respondents
opined that they wished to provide personalized care services to
mothers/clients seeking Antenatal Care Services (ANC) in their community at a fee while only 13.9% had
knowledge that obstetric screening should be done before 24 weeks
gestation. Four out of ten of the respondents scored themselves a one
(1) on the level of confidence they have using an ultrasound machines or
technology. Conclusion: There still remains a huge gap as far as training of midwives on basic ultrasound screening
is concerned. The lack of basic obstetric ultrasound screening skills is
a barrier to rolling out Point of Care
Ultrasound (POCUS) screening services. However, midwives are motivated
and willing to learn basic ultrasonography skills to further the objectives of
Universal Health Coverage (UHC). Concerted efforts should be made to train
midwives on basic obstetric ultrasonography skills in addition to availing
mobile/hand held ultrasound technology in Primary Health facilities for them to
apply the transferred skills. A sustainable business model to enable mothers
continuously afford the services is critical as well.