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Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya
Thesis (PhD)--Stellenbosch University, 2025.
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| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867613973872902144 |
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| access_status_str | Open Access |
| author | Wainaina, Grace-muira |
| author2 | Kaura, Doreen K. |
| author_browse | Kaura, Doreen K. Wainaina, Grace-muira |
| author_facet | Kaura, Doreen K. Wainaina, Grace-muira |
| author_sort | Wainaina, Grace-muira |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2025. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/134360 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:39.798Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/134360 Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya Wainaina, Grace-muira Kaura, Doreen K. Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery. Maternal health services -- Kenya Maternal health services -- Standards -- Kenya Mother and child health services -- Kenya Newborn infants -- Care -- Kenya Continuity of patient care -- Kenya UCTD Thesis (PhD)--Stellenbosch University, 2025. Wainaina, G. 2025. Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya. Unpublished doctoral thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/9afdcabd-d454-4fbb-b0b0-59b03be46b7e ENGLISH SUMMARY: Background: The Maternal and Neonatal Health (MNH) Continuum is an iterative process that a woman goes through, in which skilled birth practitioners have an opportunity to care for them and accompany them towards a positive outcome. Unfortunately, fragmentation of care, especially between the segments of the continuum, has been contributing to gaps in care, especially in the Sub-Saharan region where Kenya lies. This research highlights the need for continuity of MNH by embracing an evidence-based guideline for effective coordination. Purpose: The aim of this study was to propose evidence-based guidelines for the maternal continuum of care. The Expanded Theoretical Framework and the Integrated People Centered Health Services framework were utilized to highlight the need for continuity and coordination of care in the MNH Continuum. Methods: This was a multi method study, the first phase of which was to conduct a systematic review of studies among Skilled Birth Practitioners (SBPs) on continuity for effective coordination of care throughout the MNH Continuum. The results of the meta-aggregation enabled the formulation of interview guide questions for Phase two of the study. The second phase involved SBPs and women narrating their experiences of continuity and coordination of care through the MNH Continuum. Their experiences were then contrasted with the systematic review results through a meta-ethnographic qualitative synthesis, to generate a higher-order, third-level construct of interpretations in phase three. The fourth phase involved conducting a scoping review. The review identified and mapped available evidence-based practice recommendations within the MNH continuum. This led to a final phase which proposed adaptation of WHO recommendations, based on interpretation of the evidence. Findings: Continuity across the MNH segments improved coordination of care within transitional segments in the MNH Continuum. Therefore, the interpretation and adaptation of recommendations for these transitional segments were fundamental for enhancement of continuity in the continuum. Conclusions: Implementation of adapted recommendations for segmental and transitional continuity in coordination of care has the potential to reduce fragmentation of care in the MNH Continuum in Kenya. AFRIKAANSE OPSOMMING: Agtergrond: Die Moeder- en Neonatale Gesondheidskontinuum is 'n iteratiewe proses wat 'n vrou deurgaan, en waar bekwame geboortespesialiste die geleentheid het om hulle te versorg en op te volg vir 'n positiewe uitkoms. Ongelukkig dra fragmentasie van sorg, veral tussen die segmente van die kontinuum, by tot die gapings in sorg, veral in die Sub-Sahara-streek waarin Kenia gelee is. Doel: Die mikpunt van hierdie studie was om die ontwikkeling van bewysgebaseerde riglyne vir die moederlike kontinuum van sorg voor te stel. Die uitgebreide teoretiese raamwerk en die geintegreerde mensgerigte gesondheidsdienste-raamwerk is gebruik om die behoefte aan kontinuïteit en koordinasie van sorg in die MNG-kontinuum te beklemtoon. Metodes: Dit was 'n multimetodestudie waar die eerste fase 'n sistematiese oorsig onder bekwame geboortespesialiste (SBP's) uitgevoer is oor kontinuiteit vir effektiewe koordinasie van sorg deur die MNG-kontinuum. Die resultate van die meta-aggregering het die formulering van onderhoudsvrae vir die tweede fase van die studie moontlik gemaak. Die tweede fase het SBP's en vroue ingesluit wat hul ervarings oor kontinuiteit en koordinasie van sorg deur die MNG-kontinuum vertel het. Hul ondervindings is daarna gekontrasteer met die resultate van die sistematiese oorsig in 'n meta-etnografiese kwalitatiewe sintese om 'n hoer derde-orde konstruksie van interpretasies te genereer. Die derde fase het interpretasies van riglynaanbevelings behels. Die riglyne is verkry uit 'n omvangsbestudeering wat beskikbare bewysgebaseerde praktykaanbevelings binne die MNG-kontinuum in kaart gebring het. Dit het gelei tot 'n aanpassing van WGO-aanbevelings deur interpretasies van bewyse. Bevindinge: Kontinuiteit in die MNG-segmente het die koordinasie van sorg binne oorgangsegmente in die MNG-kontinuum verbeter. Daarom was die interpretasies en aanpassing van aanbevelings vir oorgangsegmente fundamenteel vir die verbetering van kontinuiteit in die kontinuum. Gevolgtrekkings: Die implementering van aangepaste aanbevelings vir segmentale en oorgangskontinuïteit vir koordinasie van sorg het die potensiaal om fragmentering van sorg in die MNG-kontinuum in Kenia te verminder. Doctoral 2025-11-14T14:09:37Z 2025-11-14T14:09:37Z 2025-03 Thesis https://scholar.sun.ac.za/handle/10019.1/134360 en_ZA Stellenbosch University 294 pages : illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Maternal health services -- Kenya Maternal health services -- Standards -- Kenya Mother and child health services -- Kenya Newborn infants -- Care -- Kenya Continuity of patient care -- Kenya UCTD Wainaina, Grace-muira Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya |
| title | Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya |
| title_full | Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya |
| title_fullStr | Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya |
| title_full_unstemmed | Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya |
| title_short | Development of evidence-based guidelines for coordination and continuity of care through the transitions in the continuum of Maternal and Neonatal Health Care in Kenya |
| title_sort | development of evidence based guidelines for coordination and continuity of care through the transitions in the continuum of maternal and neonatal health care in kenya |
| topic | Maternal health services -- Kenya Maternal health services -- Standards -- Kenya Mother and child health services -- Kenya Newborn infants -- Care -- Kenya Continuity of patient care -- Kenya UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/134360 |
| work_keys_str_mv | AT wainainagracemuira developmentofevidencebasedguidelinesforcoordinationandcontinuityofcarethroughthetransitionsinthecontinuumofmaternalandneonatalhealthcareinkenya |