Contribution of health workers and patient characteristics on adherence to antenatal clinic appointments in public hospitals: a case of Homabay and Kisumu County referral hospitals, Kenya

Abstract

Introduction: missed appointments account for about 56% of wasted health resources in the world. There is about 42% missed appointment rate in African medical setting. Antenatal clinics in Kenya experience about 44% missed appointment rate accounting for about 22% of wasted health resources. About 1.7 million children born between 2013 and 2017 did not receive all prescribed vaccines. About 42% and 35% of antennal appointments in Homabay and Kisumu Counties were missed in 2019. The study assessed contribution of health workers and patient characteristics on adherence to antenatal clinic appointments in public hospitals. Methods: a crosssectional research design was employed in Homabay and Kisumu County hospitals. The study included 2 hospital managers per hospital, 70 and 63 antenatal clients in Homabay and Kisumu County hospitals respectively. Patients were stratified and proportionately sampled, while hospital managers were purposively sampled. Sample size was determined using Yamane Formula. Key informant interview and selfadministered structured questionnaire were used to collect data, and analysis done using SPSS tool. Results: findings showed, in Homabay and Kisumu County hospitals respectively, that: 50 (71.4%) and 20 (40%) missed appointments due to inadequate staff responsiveness towards their needs; 50 (71.4%) and 28 (56%) due to staff attitude. Single and separated antenatal clients miss more appointments compared to married and cohabiting clients. Conclusion: there is low adherence to appointments in antenatal clinics in Homabay and Kisumu County hospitals because of poor staff attitude, inadequate staff responsiveness; and lack of sufficient education on the importance of antenatal care among mothers