Experiences of Nurses and Midwives Regarding Postpartum Care in Rural Kenyan Communities: A Qualitative Focused Ethnography Study
Maternal, neonatal and infant mortality is still high globally, but worse in low-resourced countries such as Kenya. Progress in reducing maternal mortality in Kenya is slow, with an estimated maternal mortality ratio of 400 deaths per 100,000 live births. Similarly, the infant mortality rate is tabulated at 39 deaths per 1000 live births. Given the high prevalence of maternal and newborn mortality and morbidity in low-income countries such as Kenya, it is vital to maximize nurses' and midwives'
... capacity to contribute to the reduction of this burden of disease during the perinatal period. As the main healthcare providers in rural Kenyan facilities, nurses and midwives are best positioned to provide effective maternal, newborn, and infant health (MNH) services. They provide both health promotion and disease prevention care throughout pregnancy, labor and delivery, and the early postpartum period. One way of achieving this is through effective postpartum care, a period of perinatal care that is plagued with high rates of pregnancy-related complications. A significant amount of research has been conducted on improving MNH in developing and low- to middle-income countries. However, there is a paucity of literature examining the experiences of nurses and midwives providing postpartum care in these settings. As is evident in the existing literature, nurses' and midwives' experiences and perspectives have not been explored to the fullest. This study, therefore, was guided by critical theory and Foucault's concepts of knowledge and power. Using focused ethnography (FE) as the research methodology, the study had four specific objectives: 1) To describe how the sociopolitical and cultural contexts of healthcare influence the provision of postpartum care by nurses and midwives; 2) To identify the facilitators influencing nurses' and midwives' ability to competently provide postpartum care; 3) To identify the barriers to nurses' and midwives' ability to competently provide postpartum care; and 4) To explicate nurses' and midw [...]