The Eye of Maternity: Perceptions of Nurse-Midwives on Obstetric Triage in Kiambu County, Kenya - A Phenomenological Study

Abstract

Obstetric triage (OT) is the brief, thorough, and systematic maternal and fetal assessment conducted on a pregnant woman who presents for care. Midwives are primarily responsible for conducting OT, making it important for them to have the requisite competence. This study sought to determine midwives’ perceptions regarding OT in Kiambu County, Kenya. A phenomenological approach was employed. Data was collected from 10 purposively selected participants using a key informant interview guide, recorded, and field notes taken. Transcription was done, and analysis was done using NVIVO version 12. Data was coded, classified into themes, and meanings derived from the themes. The majority of the participants had a diploma in nursing (7, 70%) with a mean age of 32.9 years. The median duration worked in maternity was 36 months. The key themes that emerged were opportunities and challenges. The most frequently mentioned opportunities were the positive labor outcomes of triage and willingness to adopt structured triage models, while high workload and a lack of enough triage equipment and supplies were the most frequently mentioned challenges to OT. This study illustrates the complexities involved in implementing obstetric triage in resource-limited settings while revealing potential areas for intervention. Recommendations have been made to develop and implement structured triage training, promote teamwork, address staffing issues, enhance the provision of equipment and supplies, and improve adherence to referral protocols.