Dataset Information

Evaluating the role of clinical officers in providing reproductive health services in Kenya.

ABSTRACT:

Background

Most sub-Saharan African countries have too few reproductive health (RH) specialists, resulting in high RH-related mortality and morbidity. In Kenya, task sharing in RH began in 2002, with the training of clinical officer(s)-reproductive health (CORH). Little is known about them and the extent of their role in the health system.

Methods

In 2016, we conducted a retrospective, quantitative two-stage study in Kenya to evaluate the use of CORH and 28 of their curriculum-derived RH competencies, to determine their contribution to expanded access to RH care. CORH were surveyed, using structured questionnaires and telephone interviews. Data on the frequency with which CORH used specified competencies were collected from health records in selected facilities.

Results

Forty-nine of all 104 CORH participated in the survey (47%). Forty-eight (98%) had worked in the clinical area, and 79% were still engaging in clinical work. All 48 worked in emergency obstetrics, emergency gynaecology, and nonemergency RH, and 38 (79%) filled clinical leadership positions. Vasectomy was least performed, by only 9 (18%) CORH. All other competencies were applied by at least half of the CORH, and 22 competencies by more than three quarters. Forty-one (84%) CORH performed caesarean section (CS). Teaching and management were other common responsibilities. Data were collected from 12 facilities and analysed for 11. They generally confirmed the initial survey findings: CORH worked as obstetrics and gynaecology consultants and used most of their competencies. Analysis was based on 118 months of theatre records. CORH made significant contributions to their facility's capacity to perform RH surgery: most respondents performed at least 25% of these surgeries. They performed an average of six CS per month and more than 25% of perineal tear repairs (33%), uterus repairs (33%), manual placenta removals (26%), bilateral tubal ligations (39%), and cervical cancer staging (27%). Some experienced CORH conducted procedures beyond their training.

Conclusions

CORH expand access to emergency RH care. Their contributions span all areas of obstetric and gynaecological care, mentoring new health workers and expanding their scope of practice. However, the generally poor status of records documenting healthcare provision limits their usability in evaluation and research.

SUBMITTER: Darwinkel MC

PROVIDER: S-EPMC6042229 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

Evaluating the role of clinical officers in providing reproductive health services in Kenya.

Darwinkel Marianne Corine MC Nduru Julius Maina JM Nabie Reuben Waswa RW Aswani John Anzetse JA

Human resources for health 20180711 1

<h4>Background</h4>Most sub-Saharan African countries have too few reproductive health (RH) specialists, resulting in high RH-related mortality and morbidity. In Kenya, task sharing in RH began in 2002, with the training of clinical officer(s)-reproductive health (CORH). Little is known about them and the extent of their role in the health system.<h4>Methods</h4>In 2016, we conducted a retrospective, quantitative two-stage study in Kenya to evaluate the use of CORH and 28 of their curriculum-der ...[more]

PMID: 29996852

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Dataset Information

Evaluating the role of clinical officers in providing reproductive health services in Kenya.

Background

Methods

Results

Conclusions

Publications

Evaluating the role of clinical officers in providing reproductive health services in Kenya.

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