Presented by: John Macharia Kiragu (First Author), University of Nairobi and Kenyatta National Hospital,
In this Quality Improvement (QI) Initiative led by John Macharia Kiragu, the focus was on enhancing maternal and neonatal care in Kenya, addressing the suboptimal adoption of evidence-based practices. The initiative targeted a peri-urban health center in Nairobi, where midwives exhibited limited knowledge and experience in dynamic birth positions, skin-to-skin care, and delayed cord clamping.
The Plan-Do-Study-Act (PDSA) model was employed, starting with capacity building for midwifery leadership through a MIDWIZE framework. An evidence-based educational training intervention was then delivered at the Kayole health center. The study observed a significant increase in the adoption of dynamic birth positions and skin-to-skin care but noted a plateau in delayed cord clamping.
The implementation costs were evaluated, and scenario analysis indicated that collaborative scenarios were cost-effective, aligning with regional midwifery and maternal health care costs. However, if the health facility bore the entire program costs unaided, they exceeded average delivery and midwifery hourly costs.
The study discussed the potential positive impacts of the adopted practices, such as reducing operative delivery and enhancing breastfeeding. Recommendations included exploring barriers to optimal delayed cord clamping adoption and alternative resource mobilization strategies for programmatic costs. The initiative’s success suggests the replicability of the MIDWIZE framework and the PDSA model for improving evidence-based maternal health care practices in resource-constrained settings.