Imp.Act Of Post .Abortion Care .And Counselling On School Performance-Case Study Of Schools In Central And Rift Valley Provinces Of Kenya

Abstract

From October to November I 998, a PRIME team conducted a baseline needs assessment

for a postabortion care (PAC) pilot initiative that PRIME was undertaking in

collaboration with the National Nurses Association of Kenya (NNAK) and the Nursing

Council of Kenya (NCK). The title of the pilot project is "Expanding Opportunities for

Postabortion Care at the Community Level through Private Nurse-Midwives in Kenya'."

The PRIME-assisted PAC initiative, including the activity described in this report, is

financed from PRIME core funds earmarked for technical leadership and field support

funds from REDSO/ESA.

In late I 998, private nurse-midwives registered with the NCK requested PRIME

assistance to include PAC in the range of preventive and curative maternal and child

health services they offer. These private nurse-midwives have their own clinics, offer

services in areas traditionally underserved by physicians (e.g. urban slums and rural

areas), and frequently care for women experiencing obstetric emergencies. In partnership

with the NNAK and with support and sanctioning from the NCK and the Primary Health

Care Division of the Kenya Ministry of Health, a PRIME-assisted pilot project was

launched in 3 provinces: Nairobi, Rift Valley and Central Provinces. The provinces were

selected following a country-wide survey of private nurse-midwives who had a current

permit from the NCK to operate a private practice.

The purpose of the needs assessment was to generate baseline data that would contribute

to the design of strategies to train, monitor and supervise private nurse-midwives as they

establish and integrate PAC services at their respective facilities. Needs assessment

findings will also be used to evaluate the extent to which the pilot project achieved its

objectives and expected results.

The needs assessment team used 4 instruments for data collection (see appendices 1-4): a

facility checklist; focus group discussion (FGD) guide for community opinion leaders;

focus group discussion guide for youth; and client exit interview guidelines.

Data were collected from 49 facilities in 3 provinces and the 151 nurse-midwives

working in those facilities. The 49 were selected from among the IO 1 facilities listed

during the inventory as a convenience sample, using criteria which included ownership of

the facility, interest in offering comprehensive PAC services and 2 nurse-midwives on

staff who could be trained to provide PAC services. Data were also collected from

community opinion leaders and youth who participated in a total of 33 FGDs and from 23

MCH/FP clients interviewed at-exit from 29 facilities (there were no clients appropriate

for interviews at the remaining 20 facilities at the time of the baseiine assessment).