KENYA – The extended role of health facility cleaners in maternity care in Kenya

by Ginger Golub, May Sudhinaraset, Katie Giessler, Kendall Dunlop-Korsness, Allison Stone

International Perspectives on Sexual and Reproductive Health February 2020

CONTEXT: A growing body of evidence indicates that non-clinical health care facility staff provide support beyond their traditional roles, particularly in low- and middle-income countries. It is important to examine the role of health facility cleaners in Kenya – from their perspective – to better understand their actual and perceived responsibilities in maternity care.

METHODS: In-depth, face-to-face interviews using a semi-structured guide were conducted with 14 cleaners working at three public health facilities in Nairobi and Kiambu Counties, Kenya, in August and September 2016. Results were coded and categorized using a thematic content analysis approach.

RESULTS: Cleaners reported performing a range of services beyond typical maintenance responsibilities, including providing emotional, informational and instrumental support to maternity patients. They described feeling disrespected when patients were untidy or experienced bleeding; however, such examples revealed cleaners’ need to better understand labor and childbirth processes. Cleaners also indicated a desire for training on interpersonal skills to improve their interactions with patients.

CONCLUSIONS: Cleaners’ direct involvement in maternity patients’ care is an alarming symptom of overburdened health facilities, insufficient staffing and inadequate training. This key yet overlooked cadre of health care staff deserves appropriate support and further research to understand and alleviate health system shortcomings, and to improve the quality of maternity health care provision.

Editor’s Note: Research in the past has similarly found that receptionists and other non-clinical staff make an important difference in the experience of attending an abortion clinic. This paper is a reminder that this remains an important area for staff training.

PHOTO: by Marco di Lauro, Pumwani Maternity Hospital, Nairobi, 5 May 2010