RU Community

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Browsing RU Community by Subject "adherence"

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    Contribution of Health Workers and Patient Characteristics on Adherence to Antenatal Clinic Appointments in Public Hospitals: A Case of Homabay and Kisumu County Referral Hospitals, Kenya
    (PAMJ - One Health, 2020-12-21) Opon, Shadrack Ochieng; Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni
    Introduction: missed appointments account for about 56% of wasted health resources in the world. There is about 42% missed appointment rate in African medical setting. Antenatal clinics in Kenya experience about 44% missed appointment rate accounting for about 22% of wasted health resources. About 1.7 million children born between 2013 and 2017 did not receive all prescribed vaccines. About 42% and 35% of antennal appointments in Homabay and Kisumu Counties were missed in 2019. The study assessed contribution of health workers and patient characteristics on adherence to antenatal clinic appointments in public hospitals. Methods: a crosssectional research design was employed in Homabay and Kisumu County hospitals. The study included 2 hospital managers per hospital, 70 and 63 antenatal clients in Homabay and Kisumu County hospitals respectively. Patients were stratified and proportionately sampled, while hospital managers were purposively sampled. Sample size was determined using Yamane Formula. Key informant interview and selfadministered structured questionnaire were used to collect data, and analysis done using SPSS tool. Results: findings showed, in Homabay and Kisumu County hospitals respectively, that: 50 (71.4%) and 20 (40%) missed appointments due to inadequate staff responsiveness towards their needs; 50 (71.4%) and 28 (56%) due to staff attitude. Single and separated antenatal clients miss more appointments compared to married and cohabiting clients. Conclusion: there is low adherence to appointments in antenatal clinics in Homabay and Kisumu County hospitals because of poor staff attitude, inadequate staff responsiveness; and lack of sufficient education on the importance of antenatal care among mothers
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    Influence of Organizational and Access Factors on Adherence to Appointments in Antenatal Clinics in Homa Bay and Kisumu County Referral Hospitals, Kenya
    (2021-08-21) Opon, Shadrack Ochieng; Tenambergen, Mwaura Wanja; Njoroge, Kezia Muthoni
    Introduction: the world wastes about 40% of health resources, and African medical setting has about 42% missed appointment rate. Kenya has 44% missed appointment rate in antenatal clinics, wasting about 22% of health resources. Five hundred and two thousand eight hundred and sixty (502,860) children were not immunized in 2017. Homabay and Kisumu Counties with 91/1000 and 149/1000 under-five mortality rates, recorded 42% and 35% missed appointment rates in antenatal clinics respectively in 2019. This study assessed influence of organizational and access factors on adherence to appointments in antenatal clinics. Methods: the study adopted cross-sectional research design across two hospitals, purposively sampled (Homabay and Kisumu County Hospitals) because of high under-five mortality and high HIV prevalence rates. Stratified and proportionate sampling were used to sample patients, and purposive sampling for hospital managers. Yamane Formula was used to determine sample size. The study comprised 133 antenatal patients (Homabay County Hospital 70, Kisumu County Hospital 63) and two hospital managers per hospital. Self- administered structured questionnaire and key informant interview were used to collect data. Results: study revealed in Homabay and Kisumu County hospitals respectively, as follows: 55 (78.6%) and 35 (70%) antenatal clients missed their appointments because of waiting time; 55 (78.6%) and 30 (60%) due to facility operating hours; and 55 (78.6%) and 25 (50%) due to opportunity cost of seeking services; and 55 (78.6%) and 20 (40%) due to facility proximity. Conclusion: there is high missed appointment rates in antenatal clinics in Homabay and Kisumu County hospitals because of poor organization of antenatal services, opportunity cost and facility location.