Evaluating the role of clinical officers in providing reproductive health services in Kenya

Table 1 Reported application of specific competencies by 49 clinical officers–reproductive health

Competency	Frequency	Percentage (%)
Emergency Obstetric Care (10 competencies)
Manage pre-eclampsia*	47	95.9
Manage postpartum haemorrhage	47	95.9
Manage puerperal sepsis	47	95.9
Manual removal of retained placenta	46	93.9
Induce and augment labour	45	91.8
Repair cervical tear	42	85.7
Perform caesarean section	41	83.7
Repair perineum 3rd and 4th degree tear	38	77.6
Secondary repair of burst abdomen after caesarean section	34	69.4
Vacuum extraction of baby	28	57.1
Gynaecological emergency care (3 competencies)
Perform manual vacuum aspiration	48	98.0
Manage gender-based violence	42	85.7
Manage ectopic pregnancy, including laparotomy	37	75.5
Nonemergency reproductive health (15 competencies)
Infertility^a	47	95.9
Visual inspection with acetic acid and visual inspection with Lugol’s iodine	46	93.9
Adolescent reproductive health-related issues^b	46	93.9
Gynaecological disorders in puberty	44	89.8
Sexual dysfunction	44	89.8
Removal of lost intrauterine contraceptive device	43	87.8
Dilatation and curettage	40	81.6
Bilateral tubal ligation^c	40	81.6
Insertion and removal of MacDonald stitch	39	79.6
Papanicolaou test	38	77.6
Gestational trophoblastic disease	37	75.5
Staging of cervical cancer	36	73.5
Cervical biopsy	35	71.4
Endometrial biopsy	25	51.0
Vasectomy**	9	18.3

*1 missing value
**9 missing values
^a For patients dealing with infertility, CORH are trained in evaluation and counselling of couples, identification and interpretation of laboratory and imaging investigations, and, to some extent, management of infertility, e.g. hydrotubation and myomectomy.
^b In light of Kenya’s high teen pregnancy rate, many government guidelines require RH services that are accessible and acceptable to the youth. Competencies of the CORH that related to youth sexual and RH care are diagnosis and management of various menstrual problems and recognition of congenital conditions, including hereditary conditions and problems such as imperforate hymen.
^c Only bilateral tubal ligation and vasectomy were included as CORH skills, because the other family planning competencies, such as intrauterine contraceptive device insertion and provision of injectable contraceptives and implants, are also done by other staff (e.g. general clinical officers and midwives).

ISSN: 1478-4491