Interdisciplinary Care Compliance with Antenatal Physical Activity and Exercises Guidelines for Management of Excessive Gestational Weight Gain for Prevention of Overweight and Obesity, Busia County, Kenya

Abstract

Gestational overweight and obesity remains one of the leading causes of adverse health consequences for women and their offspring. Despite recommended antenatal guidelines on gestational weight gain monitoring and management of excessive weight gain as a risk factor for poor pregnancy outcomes, trends continue to increase. The study determined interdisciplinary compliance to antenatal guidelines by antenatal care providers to stipulated strategies for management of excessive gestational weight gain for prevention of overweight and obesity during pregnancy in primary healthcare settings, in Busia County, Kenya. Socio-Ecological Theory guided the study. A prospective descriptive study design was adopted. The study population were antenatal care workers from level four primary healthcare settings in the antenatal clinics. Stratified sampling was used to select urban and rural health facilities while purposive sampling was used to select key informants. A sample size of 43 was selected. A structured questionnaire was administered face-to face by investigators. The data collected was entered and analysed with SPSS version 20. The study revealed majority (67.4%) antenatal care providers in the interdisciplinary team were females with 32.4% males with a ratio of 1:2. Majority (37.2%) were aged between 26 to 33 years with (46.5%) midwives nurses. Majority (58.1%) qualified with a diploma and 39.5% had worked for more than 2-5 years. Majority (76.7%) revealed screening of gestational weight gain were practiced and implemented in line with National maternal policy for early detection of gestational overweight and obesity in ANC. There was a significant relationship on age and number of years worked with a (P-Value 0.000); one’s qualification level (p-value 0.001); number of years of practice (P-value (P-value 0.003) that influenced weight gain screening that determined frequency of gestational overweight and obesity among pregnant women in antenatal clinics. Majority (46.5%) acknowledged gestational overweight and obesity were highest recorded in the second and third trimesters respectively. Majority (65.2%) recommended light aerobics. While 70% did not recommend high-intensity exercises or daily activities participation. A few (46.5%) recommended strengthening while 69.8% vigorous exercises. Majority (90.7%) were awareness of gestational overweight and obesity trends occurred between 18 to 30 years in their 2^nd and 3^rd trimesters. Despite screening of gestational weight gain, more than (75.2%) in the four hospitals had never and less often diagnosed pregnant women with gestational hypertension, diabetes mellitus, obstructed labour, prolonged labour and urinary incontinence. There is need for more proactive implementation of antenatal physical activity and exercises guidelines for management of   excessive weight gain for management of overweight and obesity among pregnant women aged between 18-30 years in their 2^nd and 3^rd trimesters. More so, there is need to screen and document pregnancy-related risks to excessive weight gain in the 2^nd and 3^rd trimesters. The study recommends further exploration interdisciplinary care compliance to prescription of supervised structured antenatal physical activity and exercises guidelines to maintain recommended weight gain for management of gestational overweight and obesity.