THE ‘MALINDI LESSONS’ – DAY 1

The University of Nairobi Innovation Fellows together with students from Aalto University ,Finland today made their first visit to stakeholders in the health sector in Malindi. We got the entire experience and lessons for you.

Visit to Venoma Private Clinic

The ‘Fetoscope Team’ at Venoma Private Clinic during their Field study.

The team interviewed a clinician at Venoma Private Clinic. The setting was a small clinic with several staff and few patients. The temperatures are high, humid and the environment is quiet. The clinician starts by giving details as regards to the management of the facility and its role in the healthcare system in Kilifi – including referral system.  She then gives information about her duties at the facility in context to maternal health.

The Lessons

  • Constant check up should be done during pregnancy to help detect complications at early stages to avoid dangers and to help in timely treatment.
  • It is only possible to monitor fetal heart rate using a fetoscope from six months after conception.
  • Maternal heart rate is subject to variation depending with physiology and state of the mother and can be confused with that of the fetal heart rate.
  • A pinard horn fetoscope is the most efficient, easy to use, cheap, portable and easily available tool to use.
  • Fetoscope accuracy depends on the experience of the midwives.
  • Accuracy is achieved by comparing results with another midwife’s readings.
  • The fetoscope sound is low and one has to be really keen or strain to listen to fetal heart rate in a noisy environment.
  • The level of accuracy can reduce as the age of midwives increases due to hearing problems.

The story of a recent mother.

The team interviewed a young mother who delivered her first child, a son, at the facility. Her son is aged 2.8 yrs and plays around happily during the interview. The mother said that a  fetoscope was used to monitor her pregnancy every time she visited the facility. It took the midwives about 3 minutes to effectively auscultate her fetus’ FHR each time during the monitoring. Sometimes the fetoscope hurts when being used on her (pressed) especially during the latter stages close to delivery. They prefer hospital services to Traditional Birth Attendants because hospitals are better equipped to handle complications.

Visit to Imani Private Clinic

The ‘Fetoscope Team’ at Imani Private Clinic in Malindi

The team interviewed a clinical officer at Imani Private Clinic in the afternoon. The setting of the interview is the consultation room of the clinical officer. The temperature out is very hot in contrast to the cool temperature in the room.

The team interviewing a clinical officer at Imani Private Clinic

The Lessons

  • Accuracy of the fetoscope depends on the experience of the user.
  • Monitoring using fetoscope is dependent on time of pregnancy, only measurable after six months from conception.
  • It is not possible to determine fetal heart rates for twins in some occasions.
  • Maternal heart rate is subject to fluctuations especially during complications.
  • The fetoscope is effective, durable and easily available.
  • A display screen that shows the heart rate would make the nurses’ experience exciting.

We believe you have learned something from this article. Watch out for the next one,  THE ‘MALINDI LESSONS’ – DAY 2  as we tell you the team’s experience on the second day of the field study. Cheers!

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