Improving Post Natal Care in Kilifi County

Globally, 50% of postnatal deaths occur within 48 hours of delivery due to maternal complications, while 50% of neonatal deaths occur within the early neonatal period. In Kenya, 62% of live births are delivered by a skilled provider, with only 63% of women receiving postnatal care (PNC). Kilifi County has a lower skilled birth attendant (SBA) rate, with 46% of deliveries attended by a skilled provider, and a lower PNC coverage rate, with 39% of women receiving PNC. To address the low PNC coverage rate in Kilifi County, Afya Pwani implemented a multi-pronged approach to increase PNC uptake and improve maternal and child outcomes. The objective of this initiative was to increase postnatal care uptake and improve maternal and child outcomes in Kilifi County. The results of this initiative were significant, with an increase in the number of women receiving postnatal care within 48 hours of delivery from 5,965 in October 2016 to September 2017 to 19,494 in the period October 2017 to October 2018, representing a 227% increase. Training of 53 healthcare providers on targeted postnatal care and essential newborn care was a key component of this initiative. The training sessions highlighted the challenges faced by healthcare providers in defining postnatal care indicators, documenting PNC using the PNC register at MCH/FP and Maternity Departments, and ensuring the availability of registers at PNC service delivery points. To address these challenges, a social media campaign was launched to improve healthcare workers' knowledge on PNC indicator definition, proper documentation practices, reporting, and ensured availability of registers at PNC service delivery points. Data verification and validation before uploading to the District Health Information System (DHIS) was also a critical component of this initiative. The results of this initiative demonstrate the effectiveness of a multi-pronged approach in increasing PNC uptake and improving maternal and child outcomes in Kilifi County. The lessons learned from this initiative highlight the importance of open discussions with healthcare providers to identify root causes of performance gaps and the potential of social media in improving service provision. Dissemination of new tools and indicator definitions should be done in a structured way to enhance clear and uniform understanding.