Empowering Primary Health Care: Expanding access to Point Of Care Ultra-Sound (POCUS) for every mother in Kenya

Abstract

Background: POCUS is a powerful tool for primary care providers, enabling real-time diagnostic assessments and guide treatment  decisions with potential to reduce unnecessary referrals and improve patient satisfaction. This study explores local situation in pregnancy  risk stratification and analyze enablers/barriers for potential integration in Kenyan health facilities.
Methods: Mixed methods approach was used for data collection. Random sampling was used to recruit health facilities. Purposive  sampling was used to get respondents for key informant interviews (KII), focus group discussions (FGD) and a participatory workshop.
Results: Total 16 FGD with pregnant moms, 20 stakeholders’ workshops, 70 KIIs, and 407 structured interviews were conducted in 18  Counties. 40% of mothers had completed secondary education. 22% had used POCUS during their pregnancies. Most (13%) had accessed  services in Level 2 facilities. Only 8% of healthcare workers had trained on POCUS. Mainly gynae clinics (65%) offered services. 17% of  mothers reported having been referred. Nuchal cord was the main cause of referral.
Conclusion and Recommendation: Despite its potential to improve pregnancy outcomes, inadequate access to diagnostic tools, unclear  policy frameworks and unskilled workforce impede adoption. Expanding access in primary care requires investments in training,  infrastructure, and quality assurance measures to ensure equitable distribution, effective and safe use by providers.