Collaborative task-sharing to enhance the Point-Of-Care Ultrasound (POCUS) access among expectant women in Kenya: The role of midwife sonographers

ABSTRACT

Unrealized maternal and child health goals continue to challenge Kenya where adverse outcomes remain high and diagnostic services are limited. The acute shortage of doctors and radiographers requires alternate human resources for health (HRH) with the ability to identify risk factors in pregnancy through Point-Of-Care Ultrasound (POCUS). A specialist radiologist and ultrasonography team partnered with midwives to adopt interprofessional task sharing and capacity building. Faculty from the Radiology Department of our hospital designed and implemented the project which was carried out at three outreach health service centres. Designing and implementing a training model to skill midwife sonographers with the capacity to accurately identify risk factors in pregnancy is an effective model to increase POCUS access. A collaborative task sharing model focused on training quality, validation of results, tracking of errors and specialist level clinical supervision yielded a safe and scalable model of HRH capacity building. Programme evaluation, verification of outcomes and dissemination of results were all monitored. The project was a successful HRH task sharing and interprofessional learning initiative involving task sharing a clearly defined suite of sonographer competencies with participating midwives. The programme increased POCUS accessibility at the three outreach clinics with proven outcomes in the early detection and referral of risk factors in pregnancy.

KEYWORDS:

• High risk pregnancy
• Kenya
• maternal health services
• midwifery
• POCUS
• task sharing
• ultrasonography

Declaration of interest

The authors report no competing interests. The authors alone are responsible for the writing and content of this article.

Additional information

Funding

Philips Medical Systems (Bothell, WA, USA) provided all the ultrasound machines, e-module, and trainers for the midwives. They fully funded this project hoping that it will be implemented in resource-poor areas. In addition, the authors would like to acknowledge the support and encouragement from the World Federation for Ultrasound in Medicine and Biology in the design and implementation of this project.