Cleaners helping patients in maternity wards – study

Hospital cleaners help patients in maternity wards in public health facilities in Nairobi and Kiambu counties, a study has found.

The cleaners, who have no medical training, admitted handing instruments to nurses during deliveries and dispensing drugs when clinical staff were absent.

They also provided emotional support to nervous patients before delivery and gave advice on immunisation of newborns.

They carry out these roles, which are not mandated or encouraged by management, largely due to a shortage of medical staff, the study states. 

The study, ‘Extended Role of Health Facility Cleaners in Maternity Care in Kenya’, is published in the latest issue of the International Perspectives on Sexual and Reproductive Health journal.

Researchers said the two facilities sampled have a high volume of patients and medical workers were overburdened.

The cleaners said they were often left to comfort patients during delivery.

“When the pain becomes unbearable, some get ahold of your hand when you are passing by. ‘Come and rub my back.’ And you just have to do it. Because when someone is pregnant, it’s not easy. You rub her for a short while, then you leave back to your job,” a 23-year-old cleaner from Kiambu county told the researchers.

This being a qualitative research, it is not statistically representative and the results cannot be verified.

However, the Health Workforce Status Report 2017 reveals a high shortage of nurses and other health workers. In Nairobi, there are about 10 nurses for every 10,000 people.

Researchers said they interviewed 14 cleaning staff, all females, aged 21 to 59. Nine worked at facilities in Kiambu and five in Nairobi county.

Cleaners had worked at their facility anywhere from four months to 17 years.

Ten had not completed secondary school, three had finished secondary school and one had completed a vocational course.

Some cleaners were involved at the postpartum stage, including sympathising with women who deliver stillborn babies.

“You try talking to her and you explain to her the way God will help her, and she will just get another child. Therefore, she should not worry. Human beings go through a lot,” said a 41-year-old cleaner from Kiambu.

The researchers said it is unclear the extent to which cleaners were giving accurate, or possibly harmful advice, or whether they referred questions to trained providers.

“Cleaners do not have the appropriate training—whether formal or informal—necessary to provide quality informational support, yet they report often being required to do so,” the study says

The researchers involved in the study were Ginger Golub, May Sudhinaraset, Katie Giessler, Kendall Dunlop-Korsness and Allison Stone.

Golub is senior manager and Allison Stone deputy country director—both with Innovations for Poverty Action NGO in Nairobi.

The others work in organisations within the US.