Browsing by Author "Namusonge, Lucy Natecho"

Now showing 1 - 7 of 7

Assessment of Women’s Experience of Care during Childbirth for Quality Improvement at Level 5 Health Facilities in Bungoma County, Kenya.
(East African Journal of Health and Science, 2022-01-05) Namusonge, Lucy Natecho; Wanzala, Maximilla N.; Wamukoya, Edwin K.
High maternal and newborn mortality is a pressing problem in developing countries. Poor treatment during childbirth contributes directly and indirectly to this problem. Many women experience disrespectful and abusive treatment during childbirth worldwide which violates their rights. In Kenya, 20% of women report having experienced some form of disrespect and abuse (D&A). Bungoma County is among the 15 counties with the worst maternal and newborn health statistics in Kenya. The maternal mortality rate is 382 per 100,000 live births and newborn deaths 32 per 1,000 live births, while skilled birth attendance is 41.4%. This study was motivated by the poor maternal and newborn indicators, rising incidences of D&A, limited formal research on respectful maternity care. The study aimed at assessing women’s experience of care during childbirth at Level 5 health facilities in Bungoma County. The specific objectives were to determine the women’s experiences of care during childbirth, to determine factors contributing to disrespect and abuse during childbirth and to identify strategies for addressing issues affecting respectful maternity care for promoting quality of maternal and newborn care. A cross-sectional descriptive study design was used. It involved 360 mothers. Analysis of quantitative data was done using SPSS. Descriptive statistics were presented in graphs, tables, frequencies and percentages. Qualitative data was analysed thematically. The prevalence of D&A was 42.2%, younger age and lower education aggravated D&A. Autonomy, privacy and confidentiality, and absence of birth companionship were major aspects of D&A. Health workforce shortage, inadequate supervision, space and beds, poor provider-patient relationships were factors leading to D&A. It was concluded that there is a need for increased incorporation of Respectful Maternity Care (RMC) in routine care, deploy more staff, avail equipment and supplies, and enhance support supervision. The study information intends to assist stakeholders in prioritising policy actions for improving the quality of maternal and newborn health outcomes and indicators.
Effect of socio-demographic factors on focused antenatal care services utilization among pregnant women at an informal settlement health centre in Nairobi, Kenya
(Primary Health Care Practice Journal, 2025-06-09) Nanzala, Phylister Hellen; Matiangi, Micah; Namusonge, Lucy Natecho
Introduction: Focused Antenatal Care (FANC) is important in standardising maternal health. FANC utilisation involves examining the sufficiency of the number of visits and the maternal healthcare services that expectant women receive. The study examined the effect of socio-demographic factors on FANC services use among expectant women at Lunga Lunga Health Centre, Nairobi County, Kenya. Methods: a cross-sectional study design was adopted to source and analyze data. The study targeted 935 expectant women in their third trimester seeking FANC services at Lunga Lunga Health Centre, of whom 272 were randomly selected to participate in the study. Data was sourced based on a structured questionnaire and data collection sheets. Frequency distribution, percentages, and multivariate binary logistic regression were used in data analysis. Results: findings showed that 9.9% of the 272 expectant women made at least 8 FANC visits to Lunga Lunga Health Centre. Multivariate binary logistic regression revealed that expectant women who had multiple parities (AOR= 0.163, 95% CI= 0.07 - 0.37, p< 0.05), had no spouses (AOR= 0.27, 95% CI= 0.12 - 0.60, p< 0.05), were Muslim (AOR= 0.11, 95% CI= 0.01 - 0.87, p< 0.05) were less likely to receive the recommended 8 FANC visits. Conclusion: the low level of FANC utilisation among expectant women from the informal settlement is attributed to socio-demographic predictors such as marital status, parity, and religion. The findings suggest sensitisation efforts to encourage women on the merits of adequate FANC utilisation. Further research should consider other predictors of FANC utilisation and target more health facilities to improve generalisation of the findings.
Modified Conceptual Framework for Respectful Maternity Care for Promoting Quality in Health Facilities
(East African Journal of Health and Science, 2025-02-09) Namusonge, Lucy Natecho
Background: Respectful Maternity Care (RMC) is fundamental to improving maternal and neonatal health outcomes, yet mistreatment during childbirth remains widespread. Existing frameworks address either interpersonal mistreatment, structural delays, or quality standards, but often lack integration and clear evaluation pathways. Objective: This study presents a modified conceptual framework for RMC that unites training evaluation, systemic barriers, and patient experiences to guide quality improvement in Level 5 health facilities. Methods: The framework integrates three models: Kirkpatrick’s training evaluation model (linking provider learning to outcomes), Bowser & Hill’s landscape analysis (categorising disrespect and abuse), and the Three Delays model (addressing barriers to care). Principal Component Analysis (PCA) is proposed to enhance analytic rigour and weighting of variables. Results: The integrated framework demonstrates how provider training (reaction, learning, behaviour, results) influences women’s experiences of autonomy, dignity, and supportive environments, ultimately reducing delays and improving maternal and neonatal outcomes. Resource requirements—including staff training, supervision, and infrastructure—and cultural adaptations, such as respecting local birthing norms and promoting birth companionship, are essential for effective application. Recommendations: The framework guides implementation through structured steps: baseline assessments, stakeholder engagement, resource allocation, context-sensitive training protocols, and continuous monitoring and evaluation using Kirkpatrick’s four levels. Conclusion: By synthesising interpersonal, systemic, and evaluative dimensions, this model offers a robust and actionable tool for advancing RMC in resource-intensive settings. It provides policymakers, facility managers, and practitioners with a pathway to institutionalise respectful, equitable, and high-quality maternity care.
Respectful Maternity Care Interventions: A Systematic Literature Review
(East African Journal of Health and Science, 2021-06-09) Namusonge, Lucy Natecho; Ngachra, Jacob Odhiambo
High maternal and new born mortality remains a pressing problem in developing settings. Poor treatment during childbirth contributes directly and indirectly to this problem at a rate of 82%. Many women experience disrespectful and abusive treatment during childbirth in facilities worldwide which violates their rights to respectful care and a threat to their right to life, health, bodily integrity and freedom from discrimination. Majority of women report to have experienced some form of disrespect and abuse during childbirth. This systematic literature review aimed at reviewing studies on Respectful Maternity Care interventions aimed at promoting Quality of Maternal and New born Care. Objectives were to assess literature on how mothers are treated during childbirth (experience of care/respectful maternity care), to find out the factors contributing to disrespect and abuse during childbirth, to identify strategies for addressing issues affecting respectful maternity care. The literature review employed a quality assessment tool RISMA’, by the WHO. Eligibility criteria was studies published between 1992 and 2020 in indexed national and international journals in English language focusing on Respectful Maternity Care interventions in promoting Quality of Maternal and New born Care. Literature was reviewed from academic databases, project reports and documents. Electronic searches included reference libraries: PubMed, Cochrane Reference Libraries, google scholar, Medline on Mega scope data bases, CINAHL, Embase data bases and grey literature. Studies meeting the following criteria were included in the review: 1) Respectful Maternity Care; 2) Facilitators to dignity and respect during childbirth; and 3) Quality of Maternal and New born Care (QMNC). Disrespect and abuse appear to be widespread and research and implementation efforts must continue, there is lack of standardized definitions, instruments hence affecting generalizability and comparability, there are no adequate available data to quantify the prevalence of these behaviours. No matter the conceptual framework used in future investigations, studies should seek to accomplish three objectives: (1) to measure the perceived and observed frequencies of mistreatment in maternal health settings, (2) to examine the macro and micro level factors that drive mistreatment, (3) to assess the impact of mistreatment on the health outcomes of women and their new borns, and 4) to employ mixed method design as an optimal strategy to evaluate mistreatment and include direct observations to bridge the gap between observed measures and participants’ self-reported experiences of mistreatment.
The AFRIDIARRHEA multimodal fusion framework for Estimating the Burden of Diarrheal Diseases Among Children Under Five in Kenya, Zimbabwe, and Somaliland
(2026-06-09) Agumba, John Onyango; Namusonge, Lucy Natecho; Ogendo, Joshua Ondura; Takavarasha, Musiiwa; Hassan, Mohamad Ahmed; Shisanya, Morris Senghor; Waswa, Lydia
Background: Accurate estimation of childhood diarrheal disease burden in Africa remains challenging because of limited surveillance, incomplete mortality data, pathogen-attribution uncertainty, and complex environmental and socioeconomic drivers. This study developed the African Diarrheal Disease Integrated Risk Intelligence and Burden Estimation Architecture (AFRIDIARRHEA), a multimodal fusion framework for estimating under-five diarrheal burden in resource-constrained settings. Methods: AFRIDIARRHEA integrates Bayesian epidemiological modeling, machine learning, temporal forecasting, geospatial analytics, pathogen attribution, environmental intelligence, and uncertainty quantification within a unified framework. Synthetic datasets representing Kenya, Zimbabwe, and Somaliland were used to evaluate mortality, morbidity, hospitalization burden, pathogen-attributed mortality, and predictive performance. Results: The framework identified substantial heterogeneity in disease burden across countries, with Zimbabwe exhibiting the highest modeled mortality and morbidity burden and Somaliland the highest hospitalization burden. Rotavirus and Shigella were the dominant contributors to pathogen-attributed mortality. The multimodal fusion model outperformed the Bayesian baseline and individual component models, achieving improved predictive accuracy, robust uncertainty calibration, and strong agreement with benchmark estimates. Conclusions: AFRIDIARRHEA demonstrates the potential of multimodal fusion modeling for integrated estimation of childhood diarrheal burden, pathogen attribution, and uncertainty in African settings. The framework provides a scalable, transparent, and policy-relevant approach for supporting vaccine prioritization, WASH investments, outbreak preparedness, and child survival programs in data-limited environments.
The role of AI in reducing maternal mortality: Current impacts and future potentials: Protocol for an analytical cross-sectional study
(PLoS One, 2025-05-14) Owoche, Patrick Oduor; Shisanya, Morris Senghor; Mayeku, Betty; Namusonge, Lucy Natecho
Background Maternal and newborn mortality remains a critical public health challenge, particularly in resource-limited settings. Despite global efforts, Kenya continues to report high maternal mortality rates of over 350 deaths per 100,000 live births and a neonatal mortality rate of 21 per 1,000 live births. Artificial Intelligence (AI)-enabled maternal healthcare interventions, such as Obstetric Point-of-Care Ultrasound (OPOCUS) and AI-driven SMS intervention on Promoting Mothers through Pregnancy and Postpartum (PROMPTS), offer innovative solutions to improve early detection, diagnosis, and maternal health-seeking behaviors. However, there is limited evidence on their usability, feasibility, and impact on maternal and neonatal outcomes. Objective This study aims to assess the implementation, user experiences, and impact of OPOCUS and PROMPTS on maternal and neonatal health outcomes in Kenya. Specifically, it evaluates their effectiveness in reducing maternal complications, improving antenatal and postnatal care utilization, and enhancing clinical decision-making while identifying potential barriers to adoption and scalability. Methods This mixed-methods, cross-sectional study will be conducted in ten counties in Kenya that have integrated AI-based maternal healthcare interventions. Quantitative data will be collected from health facility records, national health databases (KHIS), and structured surveys, while qualitative data will be gathered through key informant interviews (KIIs) with healthcare providers and policymakers, as well as focus group discussions (FGDs) with maternal health service users. Statistical analyses will include comparative pre- and post-AI implementation assessments, with thematic analysis for qualitative insights. Expected outcomes The study will generate empirical evidence on the feasibility, effectiveness, and barriers to AI integration in maternal health services. Findings will inform policy recommendations, enhance AI-assisted maternal healthcare design, and support the scaling of AI-driven interventions to improve maternal and neonatal health outcomes in Kenya and other low-resource settings. Conclusion AI-based maternal health interventions hold promise for reducing maternal mortality, improving diagnostic accuracy, and enhancing health-seeking behaviors. However, their success depends on user experiences, healthcare system readiness, and policy alignment. This study will provide critical insights for evidence-based scaling and policy integration of AI in maternal healthcare.
Women’s Persistent Utilization of Unskilled Birth Attendance: A Study of Mothers in Kakamega County, Kenya
(East African Medical Journal, 2016-11-09) Namusonge, Lucy Natecho; Kabue, Priscilla; Sharma, Rekha R.
Background: Minority of births in Sub-Saharan Africa are conducted by skilled birth attendants. Having the highest world maternal mortality ratios and most deaths being associated with lack of trained supervision at delivery, changing delivery practices is a major priority in this region. Objective: To determine the factors that contribute to persistent utilization of unskilled birth attendance by women in Kakamega County. Design: A descriptive cross-sectional study. Setting: Kakamega County, Kenya Subjects: Postnatal mothers with children aged less than six months who delivered without skilled attendance. Results: Antenatal attendance rate of 92.7% while proportion of skilled birth attendance was at 48.6%. The following factors were found to influence utilization of UBAs in the Study area: age (X2=8.65, df=3, P= 0.013), occupation (X2=10.04, df=3, P=0.006), religion (X2=19.73, df=5, P=0.0001), monthly income (X2=7.59, df=2, P=0.002), marital status (X2=10.10424, df=2, P=0.005) and education level (X2=9.472, df=4, P=0.002). Negative attitude of healthcare providers, socio-cultural practices and insecurity also enhanced utilisation of unskilled birth attendance. Conclusion: Birth preparedness should be advocated for every pregnant woman and health facilities to address the discrepancy between antenatal attendance and delivery by skilled birth attendance. We hope that the information generated from this study will be used by the policy makers leading to appropriate interventions or strategies which will reduce the number of home deliveries and maternal deaths.