KNOWLEDGE, ATTITUDE AND PRACTICESOF NURSES IN PROMOTING ANTENATALPHYSICALEXERCISES IN KAKAMEGA COUNTY, KENYA
Abstract
Antenatal physicalexercises  have  proven  to  be  beneficial.  Less  than  50% of  pregnant women worldwide   meet   exercise   recommendations.Sixty-sevenpercent(67%)   of deliveries  in  Kakamega  County  are  conducted  by  a  skilled  provider  (Nurse/midwife)  and occur  in  tier  2  and  3  health  facilities.  Maternal  mortality  in  Kakamega  County  is 316:100,000    live births.The main    objective    of    the    study    wasto    determine Nurses’/midwives'  knowledge,  attitude  and  practice  in  promoting  antenatal physicalexercisesintiers   2   and   3   health   facilities   in   Kakamega   County.The   researcher hypothesized that there would be no significant differences in knowledge levels of Nurses, their attitude and practices in tier 2 and 3 health facilities in Kakamega County as regards antenatal physicalexercises.It  is  hoped  that  the  findings  of  this  study  will  contribute  to beyond  zero  campaign  by  the  first  lady  of  Kenya.A  descriptive,  cross-sectional  study design  was  used  with  mixed  methods.  Data  was  collected  using  a  questionnaire  and  an observation  checklist.Multi-stage  sampling  was  used.Purposive  method  (the  only  tier  3Public County hospital) and systematic sampling was used to select the study sites (the tier 2  Sub-county  public  hospitals  and  private  hospital).  Stratified  proportionate  probability sampling  method  was  used  to  select  the 209 nurses’/midwives. Data was organizedusing Statistical  Package  for  Social  Sciences  software  (SPSS version  25.0)and  analyzed  using descriptive  statistics offrequency,  percentage,  mean  and  standard  deviations.  Hypothesis was  tested  using  ANOVA.The  results  showed  that  Nurses  had  limited knowledge164 (78.9%),  good  attitudes  202  (98.1%)  and  poor  practices,  1/5  themes  (20%)  according  to Blooms  cut  of  points  in  terms  of  promoting  antenatal physicalexercises.  On  knowledge, masters group had the least mean of 17.67, SD=1.53 and CI=13.9-21.5 while othersgroup had  the  highest  mean  of  19.5,SD=6.24  and  CI=9.6-29.4.  There  was  no  significant difference  in  knowledge  among  Nurses  P=0.784,np2=0.05),attitudes  were  different  at (P=<0.001,np2  =0.225),there  was  significant  association  between  knowledge and  practice (r=0.156,  p=0.026)  but  there  was  no  association  between  attitude  and  practice  towards antenatal physicalexercises  (r=0.25,  p=0.934).On  multiple  regression,  knowledge  was  a better  predictor  of  promoting  antenatal  exercises  (p=0.036)  than  attitude.  The  study concluded  that,  nurses  have  a  good  attitude  in  promoting  antenatal physicalexercises  in Kakamega County,however  the  low  knowledge  affects  their  practice  towards  the  same. The   study   therefore   recommends   dissemination   of   guidelines   on   antenatal physicalexercises for better maternal outcomes.

