Browsing by Author "Osoro, Epony Nyakong'anyi"

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    Effect of an Educational Intervention on the Utilization of Maternal Healthcare Services for High-Risk Obstetric Clients, Systematic Review
    (InternationalJournalof ProfessionalPractice (IJPP), 2024-05-02) Osoro, Epony Nyakong'anyi; Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni
    This study aims to investigate how health systems can be strengthened through timely referral of obstetric patients. In many Low and Middle-Income Countries (LMICs), maternal and newborn mortality and morbidity outcomes continue to be major health issues. Most of the deaths occur in sub-Saharan Africa and South Asia where access to maternal and newborn health care is a challenge. Strengthening health systems aims at increasing access to vital services such as maternal and neonatal care to improve health outcomes. The broad objective of this systematic review was to determine the level of effectiveness of education interventions aimed at improving timely referral of obstetric patients to higher-level healthcare facilities, with the goal of strengthening health systems and improving maternal and new-born healthcare outcomes. This study adopts a systematic review of the meta-analysis approach. For articles, six electronic databases; namely, Science Direct, Scopus, EMBASE, PubMed, PLOS One, and Google Scholar were searched. The target population was publications on obstetric patients in low- and middle-income countries. Data were analysed using meta-analysis techniques. The results of the review indicated that education and training intervention had a statistically significant impact on five outcomes; namely, maternal mortality (p=0.05), service utilization (p=0.001), number of emergency referrals (p=0.00001), and referral time (0.05), though the margin was small in the latter. These outcomes were marked with significant improvement, following the implementation of the treatment of high risk obstetric patients. However, there was lack of meaningful impact of the intervention on neonatal mortality (p=0.80). The study concluded that timely referral can be enhanced by implementing education interventions such as training expectant women and healthcare providers.
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    Factors Influencing Upward Referral System of Patients in Nairobi County
    (International Journal of Community Medicine and Public Health, 2021-08-25) Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni; Osoro, Epony Nyakong'anyi
    Background: The referral system forms main health systems coordinating a mechanism ensuring the harmonious movement of patients between different levels of health care institutions for effective and efficient service delivery. The study aimed at establishing the determinants of upward referral system of patients in Nairobi County. Methods: Cross-Sectional data collected from 204 respondents from 2May to 30June, 2021, through a structured questionnaire from level 3-5 public facilities in Nairobi County was used. Data was analyzed using SPSS. Doctors, nurses and clinical officers who have referred patients in the previous three months were included while those who had not were excluded. Results: Bivariate analysis results revealed that knowledge of referral system (r=179*, p=0.011) and complexity of patient disease (r=097, p=0.170) had positive and significant correlation with upward referral system. Multivariate analysis results showed that proximity to the referral health facility had positive and statistical significant (β4=0.640, p<0.002) to upward referral system.Conclusions: The results revealed that although healthcare workers know about the referral strategy, they lack full comprehension of the referral strategy. Patients are mostly referred when higher diagnostic equipment are needed and when the medical conditions are dire. The study recommends professional medical education to equip the human resources for health with the requisite knowledge on the referral system and establishment of effective communication systems between the lower levels health facilities and the higher or specialized facilities to ensure there a smooth referral system in Nairobi County.