Introduction:

The World Health Organization recommends to have all pregnant women to undergo an obstetric ultrasound scan before 24 weeks gestation. However this has been a challenge as a result of limited access to appropriate Point of Care Ultrasound Screening POCUS services in lower levels of developing countries Health Systems cost of care skills gap amongrncare providers and unclear regulatory policy frameworks. Obstetric Ultrasound scan helps to confirm viability of a pregnancy gestational age multiplernpregnancies and it also helps rule out fetal abnormalities early enough.

Objectives:

Methodology:

One year after intervention a cross-sectional study was carried in therntwo pilot counties of Kisii rural and Kajiado peri-urban. This followed after selected midwives in the two counties were trained on basic obstetric ultrasound screening for ANC women. A total of 366 women who were eitherrnin their last phases of pregnancy or had delivered within three months beforernthe survey were interviewed. Cumulatively the 36 midwives had screenedrn1250 mothers out of whom 18 high risk pregnancies were identified. OpenrnData Kit ODK was used to collect quantitative data and analysed usingrnSTATA version 15. Descriptive statistics were used to summarize the data testrnassociations between variables. Bivariate and logistic regression was used tornidentify predictive variables and ORs with 95 confidence intervals used tornmeasure the strength of the associations

Findings:

One year after intervention a cross-sectional study was carried in therntwo pilot counties of Kisii rural and Kajiado peri-urban. This followed after selected midwives in the two counties were trained on basic obstetric ultrasound screening for ANC women. A total of 366 women who were eitherrnin their last phases of pregnancy or had delivered within three months beforernthe survey were interviewed. Cumulatively the 36 midwives had screenedrn1250 mothers out of whom 18 high risk pregnancies were identified. OpenrnData Kit ODK was used to collect quantitative data and analysed usingrnSTATA version 15. Descriptive statistics were used to summarize the data testrnassociations between variables. Bivariate and logistic regression was used tornidentify predictive variables and ORs with 95 confidence intervals used tornmeasure the strength of the associations undergone routine ultrasound screening before 24 weeks of gestation with thernaverage distance travelled by majority 45 of the respondents to access thernPOCUS service being 3 - 5 km. The need to confirm a pregnancys gestationrnwas the major 68.1 motivator for seeking the service in the two pilotrncounties. Employment status household income education level pregnancyrngestation and distance to the facility had a statistical significance P 0.05rnwith ultrasound utilization. Highest education level pregnancy gestation andrndistance to the nearest ultrasound screening facility were found to significantly predict the likelihood of utilizing the ultrasound services P 0.05.rnThe initial training and continuous hands-on coaching of midwives by TOTsrncontributed a lot to acquisition of the desired basic obstetric ultrasoundrnscreening skills.

Results:

Conclusion:

: Women in developing countries are eager tornaccess obstetric ultrasound screening services but for limited opportunitiesrnand sustainable implementation frameworks on Point of Care UltrasoundrnScreening POCUS services. Training and continuous coaching of frontlinernhealth professionals are critical in deployment of POCUS but there is limitedrnaccess to standardised training content.rnPrenatal ultrasound covers all aspects of ultrasound imaging tests performedrnduring pregnancy for a variety of reasons. It remains one of the most importantrnadvances in antenatal care worldwide given its documented benefits. Key barriers to utilization of this important service include distance to the facilities inadequate knowledge on the benefits of ultrasound services and the rising cost ofrnthese services in the health facilities. From this project there is evidence that obstetric ultrasound can be cost-effectively decentralized to PHC settings to improve on the quality of antenatal care.

Author(s):

Focus County(s):

Kajiado County

Programme Area(s):

Biotechnology

Research Priority Area(s):

Disease Domain(s):

maternal Health

Publication Date: 01.Jan.1970

Conference Title:

Venue: