International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 1, pp: (174-178), Month: April 2020 - September 2020, Available at: www.researchpublish.com
Strategic interventions in reducing obstetric risks associated with late age pregnancy among childbearing women in Kakamega County, Kenya Millicent Ambetsa Masinde Muliro University of Science and Technology, Kakamega County, Kenya
Abstract: Maternal age at conception seems to have a significant correlation with pregnancy and childbirth outcomes. Classically, very young childbearing women (less than 18 years) and above 35 years have been classified as high-risk categories. Strategic interventions to reduce obstetric risks found among these childbearing women seem to be lacking. There is need to reduce the effect of obstetric risks associated with late age pregnancy outcomes among the elderly primigravidas by evaluation of existing strategic interventions. Methods; Cross sectional survey research design was used, childbearing women and selected hospital personnel in 3 selected hospitals and tertiary institutions in Kakamega County were sampled. Purposive and stratified sampling strategies were used. The sample size was determined using Fisher’s formula, which was 177 childbearing women attending clinic in the 3 health facilities, 177 child bearing women from tertiary institutions and 30 medical personnel from the various institutions. Data collection was carried out using structured questionnaires, focused group discussions, interview guides and observation checklists of the medical equipment in the selected hospitals. Quantitative data was analyzed using SPSS and correlation techniques. Qualitative methods were used to analyze data from focus group discussions and key informant interviews. Results: Healthcare facilities in the county were not fully equipped to deal with the adverse complications that come up with late age pregnancy. Conclusion: Hospitals should be adequately equipped with adequate personnel and facilities such as Intensive Care Unit/Neonatal Intensive Care Unit to cater for this emerging trend. Keywords: Elderly Primigravidas, Intervention, maternal, birth outcomes.
1. INTRODUCTION Every year globally, an estimated 810,000 women die as a result of pregnancy or childbirth related complications (WHO, 2017). Developing regions account for approximately 99% (302, 000) of the global maternal deaths with Sub-Saharan Africa alone accounting for roughly 66% (201, 000), followed by Southern Asia 33% (66,000) (WHO, 2015). As at 2015, the two regions with the highest MMR were sub-Saharan Africa (546; UI 511 to 652) and Oceania (187; UI 95 to 381) (WHO, 2015). The highest incidence of maternal and perinatal mortality occurs around the time of birth with majority of deaths occurring within the first 24 hours after birth (WHO, 2014). The estimated lifetime risk of maternal mortality in high-income countries is 1 in 3300 in comparison with 1 in 41 in low-income countries (WHO, 2015). More than 1,000 women die for every 100,000 births in Eritrea, Ethiopia, Mozambique and Rwanda. In many other countries in the region more than 500 women die for every 100,000 births; while in other regions, women have a considerably lower lifetime risk: one in 50 in South Asia and North Africa, and one in 160 in Latin America (World Bank, 2011; WHO, 2014).
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