Factors Influencing Provision of Nutrition Education and Counselling To Pregnant Women by Nurses during Antenatal Care in Nairobi County.

Abstract

Good maternal nutrition is essential for health, development and reproductive performance of the pregnant woman, and for the growth, survival and general health of the child. One strategy for ensuring pregnant women get information on the importance of adequate nutrition is through nutrition education and counselling. However many barriers hinder effective provision of nutrition education and counselling; one may be inadequate nutrition knowledge by nurses among other factors. The objective was to determine the factors that influence provision of nutrition education and counselling to pregnant women who attend antenatal care by nurses in Nairobi County. A cross-sectional descriptive study was used. The sample comprised of 150 nurses working in the antenatal clinics from 30 health centres in Nairobi County. A semi-structured self-administered questionnaire was used to collect quantitative data, and seven key informant interviews with clinic in-charges for qualitative data. Data was analysed using SPSS version 21. Descriptive statistics was done on all variables. The chi-square tests was used to determine relations between key study variables. Nurses who had a clear understanding of nutrition education and counselling were 36%. The nurses who had knowledge on the importance of nutrition to birth outcomes were more likely to provide NEC (P=0.002). Nurses self -perceived knowledge and skills for provision of nutrition education was 34%. 66% reported that they were not adequately trained. Inadequate knowledge on was similar to all levels of nursing training, whether trained in private or public institutions. Majority (73%) reported they provided nutrition education in group sessions. However the content and quality provided is likely to be affected by inadequate knowledge and skills of nurses and lack of structure. 47% reported they had guidelines at the health facilities. In conclusion, this study has found that nurses' self—perceived knowledge and skills for provision of nutrition education and counselling was inadequate. Secondly. lack of structure lead to inconsistency in the content and quality provided. Thirdly, unavailability of guidelines and irregular use affected delivery of services. It is recommended that basic nursing training should provide trainees with adequate competences. Nurses should have continuing education on nutrition to enhance their knowledge and skills. There should be a structure to guide and ensure uniformity of NEC service provision and guidelines should be provided to all health facilities and used as reference materials.