Quality improvements contributing to effective midwife-led care : a Minor Field Study in Nairobi, Kenya

Abstract: This study was a sub-study based on the MIDWIZE capacity building program for public health officials in maternal and child health. This is a leadership program where participants conduct a quality improvement project at a selected health facility in their respective country. Implementing quality improvements with evidence-based methods such as dynamic positions, perineal protection, and intrapartum support can have a positive effect on the mothers and newborns outcomes, essential to reach the relevant goals of Agenda 2030.  The study aimed to describe maternity nurses’ experiences of implementing a quality improvement project at a health facility in Nairobi, Kenya.  The chosen design for this study included a qualitative method with nine individual semi- structured interviews. The participants were maternity nurses working in the antenatal, labour, and postnatal ward at the facility, Kianda 42. Data analysis was processed through inductive content analysis.  The findings resulted in two main categories, where the first category was titled Implementing dynamic positions, perineal protection, and intrapartum support with the subcategories The quality improvements positive effects, and Challenges with implementing the quality improvements The second category was titled Necessities needed to move forward with the subcategories Emotional necessities, Material and political necessities, and also Proposals on how to spread knowledge onwards.  Through implementing quality improvements, the maternity nurses had the opportunity of developing professionally. With methods such as dynamic positions, perineal protection, and intrapartum support there is a big possibility of reducing interventions and minimising complications for mothers and newborns. This study is of great importance due to it presenting the maternity nurses’ experience of implementing quality improvements, which can improve this project and future similar projects