Re-imagining obstetric triage in Kenya: Effects of a novel structured obstetric triage model on nurse-midwives’ competencies and patient waiting time - A quasi experimental study

Problem

Maternal and perinatal mortality and morbidity remains high in Kenya, partly attributable to the third delay.

Background

Structured frameworks for obstetric triage have been shown to improve maternal and neonatal outcomes globally, and anecdotal evidence suggests that there is no formal framework for obstetric triage in Kenya.

Aim

To pilot a Structured Integrated Obstetric Triage Model (SIOTEL) in Kiambu County Kenya and assess its effect on nurse-midwives obstetric triage competencies and patient waiting time.

Methods

A quasi-experimental design was applied. Study population included 40 nurse-midwives and 455 patient files from labour wards of the two hospitals. The intervention was a 3-scale client assessment tool. A baseline survey was conducted to explore the nurse-midwives’ competencies on obstetric triage, as well as the patient waiting time. The model was then developed, training was conducted for the nurse-midwives, and the tool implemented. An end line survey was conducted to assess effect of the model on the study variables. Quantitative data was analysed using STATA & t-test was used to check for differences between the means and the data presented using tables and graphs.

Findings

Implementing the SIOTEL resulted in improved midwives’ obstetric triage knowledge, practices and patient waiting time with no effect noted on their attitudes in the intervention facility.

Conclusion

The study highlights the significant improvement in competencies and patient waiting time resulting from structured obstetric triage.

Reporting method

The authors have adhered to SQUIRE 2.0 Guidelines