Contextual Factors Influencing the Retention of BEmONC Knowledge and Skills among Skilled Birth Attendants in Western Kenya

Background: Globally, maternal mortality rate (MMR) fell by nearly 44% from 385 maternal deaths per 100,000 live births in 1990 to an estimated 216 deaths per 100,000 live births in 2015 (Wang, 2021).Most of the maternal deaths occur in low- and middle-income countries, with sub-Saharan Africa accounting for 66 per cent of the maternal deaths (Onambele et al., 2022). Kenya saw a significant drop in MMR from of 605 in 2010 to 510 in 2015 while the deliveries by skilled birth attendants increased from 44% in 2008-09 to 62% in 2014. Besides, health facility deliveries increased from 43% to 61% (KDHS 2014). The improved maternal health indicators have been attributed to trainings of healthcare workers on maternal and newborn healthcare, improved in-service training, continuous supply of obstetric basic and emergency equipment and supplies, improved referral systems and periodic monitoring and evaluation among other interventions. However, MMR remains very high and there exists in-country disparities in the rate of maternal deaths. Kisumu and Vihiga counties are at 597 and 531 maternal deaths per 100,000 live births, respectively. Objective: To explore the contextual factors influencing the retention of BEmONC knowledge and skills among skilled birth attendants in Western Kenya. Methods: The study employed a descriptive phenomenological approach to explore the contextual factors influencing the retention of BEmONC knowledge and skills among skilled birth attendants in Western Kenya. Purposive sampling technique was used to select 30 participants for two focused group discussion (FGDs) conducted between October and November 2021.The data were analyzed via inductive thematic analysis. Results: The thematic areas fell into six categories: The perspective of individual SBA, structural level perspective; sub-theme; infrastructure and facilities, human resource, logistic and supplies: Transportation and accessibility, financial barriers, information and awareness; cultural ...