Skilled birth attendants' experiences of continuity for effective care coordination in Kenya: an interpretive phenomenology

Abstract

Background/Aims Skilled birth attendants are vital in implementing and supporting maternal and neonatal care. Continuity of care enables coordination through the segments of the maternal and neonatal health continuum, from preconception to postpartum care. The aim of this study was to explore the experiences of skilled birth attendants in relation to providing continuity of care and effective coordination through the segments of the maternal and neonatal health continuum in Kenya. Methods An interpretive phenomenological approach was used in conducting 11 interviews with skilled birth attendants from four selected counties of Kenya using semi-structured guides. Interviews were carried out between June 2021 and January 2023. Participants were asked about their experiences of providing care during preconception, pregnancy, labour, birth and postpartum, as well as their perceptions of the health system in relation to providing continuity of care. Data were analysed using the van Manen approach. Results The themes were decisions during preconception care, enabling the antenatal journey, transitioning from pregnancy to birth and creating an enabled environment. Conclusions Skilled birth attendants highlighted the need for an enabled environment to provide appropriate care, emphasising the lack of understanding of the content in preconception care and lack of an appropriate site at the health facility to provide preconception care. Skilled birth attendants need an enabling environment in order to support women in each segment of the maternal and neonatal continuum and during transitions between segments. Implications for practice Skilled birth attendants' experiences should be considered when developing and reviewing guidelines for care across the maternal and neonatal health continuum. Skilled birth attendants need training and education on continuity and coordination of care.