CHAPTER FOUR: DATA ANALYSIS AND PRESENTATION

4.0. Introduction.
This chapter presents the results of the study on factors associated with Puerperal Sepsis among
mothers attending postnatal clinic at 6 weeks in Kapsabet Referral Hospital. The findings are
based on data collected from a respondents and an organized into demographic information,
socio-economic factors, knowledge levels hospital valuated factors, viral presentations such as
bar charts are included to enhance understanding and clarity.

4.1. Response rate.

Out of the 100 participants targeted 91% respondents completed and returned the questionnaires
yielding 91% response rate. The high response rate ensures the reliability of the findings.

4.1.0. SECTION A: DEMOGRAPHIC INFORMATION.

This section details the demographic characteristics of the respondents who participated in this
study. A total of 91% mothers attending postnatal clinic at 6 weeks at Kapsabet Referral
Hospital were involved their demographic data is presented below categorized by age,
educational background, marital status, religion, number of children (purity), place of residence
and living arrangement with spouses.

4.1.1 Age Distribution

Among the respondents 28 were age between 15-25years (30-80%). 26 were age between 26-
36years (28.6%), 21 were age between 37-47years (23.1), 16 were between age 48years and
above (17.6%).

Age Distribution
30

25

20
15 - 25 Years
15
26 - 36 Years
10 37 - 47 Years
5 48 Years and above

0
15 - 25 26 - 36 37 - 47 48 Years
Years Years Years and above

Figure 4.1.1: A bar graph indicating the age distribution of respondents

1
 4.1.2 Education Level
In the study 17 (18.30%) of respondent attained primary level of education 39 (42.86%)
respondents attained secondary level of education 35 (38.46%) respondents attained their
college and university level.

Education Level

18.68%
38.46% Primary
Secondary

(42.86% College/University

Figure 4.1.2: A pie chart indicating the education level of respondents

4.1.3 Marital Status

Among the respondents 32(35.16%) were single, 43 (47.25%) was the respondents were
married, 6(6.59%), widowed 2(2.20%) of the respondents were divorced , 8(8.79%) were
separated.

Marital Status
50
45
40
35
Single
30
Married
25
Widowed
20
Divorced
15
Separated
10
5
0
Single Married Widowed Divorced Separated

Figure4.1.3: A bar graph indicating the marital status of respondents

2
 4.1.4 Religion
Respondents were categorized into 4 main religions affiliations. Christian predominately all
respondents.

4.1.5 Parity (Number of Children).

In the study 4(4.40%) of the respondents had no children 26(28.57%) of the respondents had
one child 32(35.16%) had to children, 14(15.38%) of respondents had 3 children 15(16.48%)
of the respondents had more than 3 children.

Parity (Number of Children)

35

30

25 None
20 1 Child
15 2 Children
10 3 Children
More than 3
5

0
None 1 Child 2 Children 3 Children More than 3

Figure 4.1.5:A flow chart on Parity distribution

4.1.6 Place of Residence

In the study 19(20.88%) of the responded lives in Mosop, 21(23.08%) live Engwen
14(15.38%) of respondents live in Chasumoi, 17(15.38%) of respondents live in Aldai,
12(13.19%) of respondents live in Nandi Hills, 8(8.79%) of respondents live in Tinderet.

PLACE OF RESIDENCE FREQUENCY PERCENTAGE

Mosop 19 20.88%
Emgwen 21 23.08%
Chesumei 14 15.38%
Aldai 17 18.68%
Nandi Hills 12 13.19%
Tinderet 8 8.79%
TOTAL 91 100%
Table 4.1.6: A table showing the distribution of respondents deepening on their places of
residence
3
 4.1.7 Living with a Spouse
Among the respondents 61 (67.03%) live with their spouse and 30 (32-97%) respondents do
not live with their spouses.

Living with a Spouse

32.97%

Yes
67.03%
No

Figure 4.1.7: A pie chart indicating number of respondents living with their spouses

4.2.0. SECTION B: LEVEL OF KNOWLEDGE ASSESSMENT

This section evaluates the respondents’ knowledge of puerperal sepsis including their
understanding of its definition signs, risk factors and effects. The findings provide insight into
the extent of awareness among mothers attending postnatal care at six weeks at Kapsabet
Referral Hospital.

4.2.1 Awareness of Puerperal Sepsis

In the study when asked if they were aware of puerperal sepsis the responses were as
follows:- 53(58.2%) were aware of puerperal sepsis, 38 (41.8%) of respondents were not aware.

Awareness of Puerperal Sepsis

41.8%

58.2% Yes
No

Figure 4.2.1: A pie chart on awareness of Puerperal Sepsis

4
Among the respondents aware 24 ( 45.3%) source of information was from health care
providers 19 (35.8%) source of information was from social media and 10 ( 18.9%) source of
information was from friends and family.

SOURCES OF INFORMATION FREQUENCY PERCENTAGE

Health care providers 24 45.3%
Social media 19 35.8%
Friends and family 10 18.9%
Table 4.2.1: A table displaying source of information on Puerperal Sepsis

4.2.2 Knowledge of Signs of Puerperal Sepsis

Among the respondents 55 (60.4%) were able to identify the signs of fever, abdominal pain,
foul smelling vaginal discharge 20 (20.0%) were able to identify the signs as weight gain
frequent, urination and 16 (17.6%) were able to identify the signs as vaginal bleeding and lack
of appetite.

Knowledge of Signs of Puerperal Sepsis

60

50

40

Fever
30
Weight pain
Vaginal bledding
20

10

0
Fever Weight pain Vaginal bledding

Figure 4.2.2: A bar graph Knowledge of signs of Puerperal Sepsis

4.2.3 Experience of Signs of Puerperal Sepsis

In the study when asked if they had experienced any signs of Puerperal Sepsis 18 (19.0%) of
respondents had experienced signs 73 (80.2%) of respondents had not experienced any signs of
Puerperal Sepsis.
5
 Experience of Signs of Puerperal Sepsis

19.8%

Yes
80.2% No

Figure 4.2.3: A pie chart indicating respondents with experience of signs of Puerperal Sepsis
Among the respondents who experienced the signs of Puerperal Sepsis 12 (66.7%) respondents
reported. Fever as the sign 12(66.7%) respondents reported abdominal pain and 10 (55.6%)
respondents reported foul smelling vaginal exchange as the sign they experienced

SIGNS FREQUENCY PERCENTAGE

Fever 12 35.29%
Abdominal pain 12 35.29%
Foul-smelling vaginal discharge 12 29.41%
Table 4.2.3: A table indicating signs of Puerperal Sepsis as experienced by respondents

4.2.4 Familiarity with Risk Factors of Puerperal Sepsis

Among the respondents asked if they were familiar with the risk factors associated with
puerperal sepsis. Their responses were 41(45.1%) were familiar, 50(51.9%) of respondents
were not familiar with the risk factors of puerperal sepsis.

Familiarity with Risk Factors of Puerperal Sepsis

45.1%
54.9% Yes
No

Figure 4.2.4: A pie chart showing familiarity with risk factors of Puerperal Sepsis.
6
Among the respondents familiar risk factors of puerperal sepsis 2(4.9%) gave obesity, diabetes
and poor hygiene as examples of the risk factors 35(85.4%) gave UTI’s and retained products
of conception as examples of the risk factors and 4(9.8%) gave age menopause and urinary
catheterization as examples of the risk factors.

RISK FACTOR FREQUENCY PERCENTAGE

Obesity, diabetes, and poor hygiene 2 4.88%
UTI’s and retained products of conception 35 85.37%
Age, menopause, and urinary catheterization 4 9.76%
Table 4.2.4: A table on knowledge of Puerperal Sepsis risk factors

4.2.5 Awareness of Effects of Puerperal Sepsis

Among the respondents asked whether they were aware of the effects of puerperal sepsis after
child birth. The responses were 34 (37.4%) were aware of the effect of puerperal sepsis, 57
(26.5%) were not aware of the effects of puerperal sepsis.

Awareness of Effects of Puerperal Sepsis

37.4%
Yes
62.6%
No

Figure 4.2.5: A pie chart on awareness of Effects of Puerperal Sepsis

Among the respondents aware of the effects of puerperal sepsis 1(2.9%) respondent reported
premature birth as an effect. 9(26.5%) reported shock as an effect of puerperal sepsis
13(38.2%) reported pelvic inflammatory discussion as an effect of puerperal sepsis and
11(32.4%) reported infertility as an effect of puerperal sepsis.

7
 EFFECTS FREQUENCY PERCENTAGE
Premature birth 1 2.9%
Shock 9 26.5%
Pelvic Inflammatory Disease (PID) 13 38.2%
Infertility 11 32.4%
Table 4.2.5: A table on Effects of Puerperal signs

4.3.0. SECTION C: SOCIO-ECONOMIC FACTORS ASSOCIATED WITH

PUERPERAL SEPSIS

This section assesses the socio economic factors contributing to the occurrence and
management of puerperal sepsis among mothers. Factors such as employment, income access to
health care and affordability of services was analyzed the findings underscore the impact of
economic and social circumstances on maternal health outcomes.

4.3.1 Respondents’ Occupation

Among the respondents’ 33 (36.26%) were employed, 41 (45.05%) were self-employed and
17 (18.68) were unemployed.

Respondents’ Occupation

18.68%
36.26% Employed
Self employed
unemployed
45.05%

Figure 4.3.1: A pie chart on respondent occupation

4.3.2 Monthly Income

Among the respondents 8(9.76%) monthly income was 2,000 – 4,500, 25 (30.49%) monthly
income was 4,500-10,500, 7(32 – 93%) respondent monthly income was 10,500 – 20,500,
11(13.41%) monthly income was above 20,000 shillings and 11 (13.41%) respondents
monthly income and 11 (13.41%) respondents monthly income was less than 2,000 shillings.
8
 Monthly Income
30
25
20 Kshs. 2,000 - 4,500
15 Kshs. 4,500 - 10,500
10 Kshs. 10,500 - 20,500
5 Above Kshs. 20,500
0
Less than Kshs. 2,000
Kshs. Kshs. Kshs. Above Less than
2,000 - 4,500 - 10,500 - Kshs. Kshs.
4,500 10,500 20,500 20,500 2,000

Figure 4.3.2: A bar graph on Monthly income

4.3.3 Alternative Sources of Income

Among the respondents they indicated additional sources of income 35 (38.46%)
respondents indicated farming 20 (21-98%) indicated small shops/hotels , 15(16.48%)
indicated livestock keeping, 5(5.49%) indicated owning and renting property, 16(17.58%)
respondents indicated husbands income as alternating source of income.

Alternative Sources of Income

Farming
17.58%
Small Shops/Hotels
5.49% 38.46%
Livestock keeping

16.48% Owning and renting out

property
Husband's income
21.98%

Figure 4.3.4: A pie chart on alternative sources of income

9
4.3.4 Sufficiency of Income to Meet Needs
In the study respondents were asked whether their earning meet all their needs 22 (24.18%)
respondents responded with yes and 69 (75.82%) responded with no.

Sufficiency of Income to Meet Needs

24.18%

Yes
75.82% No

Figure 4.3.4: A pie chart on sufficiency of income to meet needs

4.3.5 Access to a Balanced Diet

In the study respondents were asked if they are able to afford a balanced diet daily , 29
(31.87%) of respondents were able to afford a balance diet and 62 (68.13%) of respondent
were unable to afford a balance diet daily.

Access to a Balanced Diet

31.87%

Yes
68.13%
No

Figure 4.3.5:A pie chart on access to a balanced diet

10
4.3.6 Proximity to Health Facilities
In the study the respondents distance from home to nearest health facility was as follows:
22(24.18%), less than 1 kilometer, 33 (36.26%), 1-2 kilometers 27 (26.67%) , 3-4 kilometers
and 9 (9.89%) responded distances is above 5 kilometers from home to nearest health facility.

Proximity to Health Facilities

35

30

25

20 Less than 1 kilometer

15 1 - 2 kilometers
3-4 kilometers
10
Above 5 kilometers
5

0
Less than 1 1-2 3-4 Above 5
kilometer kilometers kilometers kilometers

Figure 4.3.6: A bar graph proximity to a health facilities

4.3.7 Means of Transport to Health Facilities

Among the respondents 29 (31.87%) reported walking as primary means of transport,
40 (43.96%) reported public transport as primary means of transport and 22 (24.18%)
respondents reported private car as primary means of transport to health facility.

Means of Transport to Health Facilities

24.18%
31.87%
Walking
Public transport
Private car

43.96%

Figure 4.3.: A pie chart on means of transport to health facility

11
4.3.8 Affordability of Maternal Healthcare Services
Among the respondents 41 (45.05%) were able to afford maternal health care services and 50
(54.95%) of respondents were unable to afford maternal health care.

Affordability of Maternal Healthcare Services

45.05%
54.95% Yes
No

Figure 4.3.8: A pie chart on affordability of Maternal healthcare services

4.4.0. SECTION D: HOSPITAL-RELATED FACTORS ASSOCIATED WITH

PUERPERAL SEPSIS
This section focuses on health care facility related figures that contribute to the prevalent of
puerperal sepsis. Issues such as availability of maternal hospitals, hygiene practices and
postnatal care services were analyzed to understand that role in pre disposing mothers to
puerperal sepsis.

4.4.1 Availability of Maternity Hospitals

Among the respondents when asked if they have enough maternity hospitals in their area 36
(39.6%) responded with yes and 55 (60.4%) with no respondents reported they were no enough
maternal hospitals.

12
 Availability of Maternity Hospitals

39.6%
60.4% Yes
No

Figure 4.4.1: A pie chart on availability of maternity hospitals

4.4.2 Challenges in Health Facilities During Delivery and Postnatal Period

In the study respondents reported the following challenges in health facilities 25 (27.5%)
reported shortage of staffs, 30 (33%) reported overcrowding of patients , 22 (24.2%) reported
lack of supportive attendance during delivery, 15 (16.5%) respondents reported lack of
resources (medications) as challenges in health facilities during delivery and postnatal period.

Challenges in Health Facilities During Delivery

and Postnatal Period
35
30
25
20 Shortage of staff
15 Overcrowding of patients
10 Lack of Supportive attendance
5
Lack of resources
0
Shortage of Overcrowding Lack of Lack of
staff of patients Supportive resources
attendance

Figure 4.4.2: A bar graph on Challenges in health facilities during delivery and postnatal
period.

13
4.4.3 Healthcare Providers’ Hand Hygiene Practices
Among the respondents when asked how frequently healthcare providers practiced hand
hygiene based and after attending them 26 (28.6%) reported they always did, 35 (38.5%)
reported they did most of time, 24 (26.4%) reported they did occasionally and 6 (6.6.%)
reported they rarely performed hand hygiene practices.

Healthcare Providers’ Hand Hygiene Practices

6.6%

28.6% Always
26.4% Most of the time
Occasionally
Rarely
38.5%

Figure 4.4.3: A pie chart on healthcare providers’ and hand hygiene practices

4.4.4 Cleaning and Disinfection of Hospital Areas

In the study respondent were asked about the regularly of cleaning and disinfections in hospital
room, labour and delivery units. 50 (54.9%) respondents reported it was done on daily basis, 23
(25.3%) reported it was done regularly but not daily, 10 (11%) respondent reported it was done
infrequently and 8 (8.8%) reported they were not sure if cleaning and disinfection was done in
hospital areas.

Cleaning and Disinfection of Hospital Areas

8.8%

11% Daily basis

Regularly
54.9% Infrequently
25.3%
Not sure

Figure 4.4.4: A pie chart on cleaning and disinfection of hospital areas

14
4.4.5 Timing of First Postnatal Clinic Attendance
Timing of first postnatal clinic attendance among the respondents 27 (30.8%) respondents
attended at 0-2 weeks, 48 (54.9%) attended 2-6 weeks 11(12.1%) attended after 6 weeks and
5(5.5%) did not attend postnatal clinic.

Timing of First Postnatal Clinic Attendance

60

50

40
0 -2 Weeks

30 2 - 6 Weeks
After 6 Weeks
20
Did not attend

10

0
0 -2 Weeks 2 - 6 Weeks After 6 Weeks Did not attend

Figure 4.4.5: A bar graph on timing of first postnatal clinic attendance

4.4.6 Screening for Infections During Postnatal Clinic

In the study respondents were asked if they were screened for infections during postnatal visits
24 (26.4%) imported routing screening conducted, 41 (45.1%) reported screening conducted
inconsistently and 26 (28.6%) respondent reported no routine screening done to screen for
infections.

Screening for Infections During Postnatal Clinic

28.6% 26.4%
Routine screening
Inconsistently screening
No routine screening

45.1%

Figure 4.4.6: A pie chart on screening for infections during postnatal clinic
15
4.4.7 Postnatal Symptoms Experienced
Among the respondents 14 (15.4%) experience foul smelling discharge, 3 (3.3%) experienced
feeling of illness and discomfort, 2 (2.2%) experienced fever, 17(18.7%) experienced pelvic
pain and 55 (60.4%) of respondents experienced none of the above symptoms.

Postnatal Symptoms Experienced

15.4%
3.3%
Foul smelling discharge
2.2%
Illness and discomfort
fever
60.4% 18.7% Pelvic pain
None of the above

Figure 4.4.7: a pie chart on postnatal symptoms experienced

4.4.8 Awareness of Puerperal Sepsis Cases in the Community
In the study respondent were asked if they heard of puerperal sepsis cases in their local
community on health care facilities 12(13.2%) respondents lead multiple cases, 40 (44%)
respondents had never heard of cases of puerperal sepsis in the community

Awareness of Puerperal Sepsis Cases in the Community

13.2%

Multiple cases
22%
Fewer cases
42.8% Never heard any case

Figure 4.4.8: A pie chart on awareness of Puerperal Sepsis

16
CHAPTER FIVE: DATA ANALYSIS AND INTERPRETATION.

5.1 INTRODUCTION.
This chapter entails the analysis of the data collected as well as the discussion of the research
findings. The findings are in relation to the respective research questions that guided this study.
The content of the chapter are the descriptive statistics i.e. characteristics of the sample and
their position as well as the inferential analysis which is the assessment of which is assessment
of factors associated with puerperal sepsis among mothers attending post natal clinic at 6 weeks
in Kapsabet referral hospital.

5.2 RESPONDENT RATE.

A total of 91 out 100 fully filled and returned the research questionnaire. The returned
questionnaires used in this study was 91% and this was therefore considered to provide
adequate and reliable information on factors associated with puerperal sepsis among mothers
attending post natal clinic at 6 weeks in Kapsabet referral hospital.it has been argued that
potential bias could result from low response rate (Bricks and Williams, 2013) and hence in this
study, high rate was associated with high reliability in information gathered.

5.3 SECTION A: DEMOGRAPHIC DATA

5.3.1 Age Distribution
According to Figure 4.1.1: A bar graph indicating the age distribution of respondents The
results indicate that the majority of the respondents (30.8%) were aged between 15–25 years,
followed closely by those in the 26–36 years category (28.6%). This shows that younger
mothers (under 36 years) constituted a significant portion (59.4%) of the study participants,
which aligns with the typical reproductive age bracket. Fewer respondents were in the 37–47
years (23.1%) and 48 years and above (17.6%) age brackets, which could suggest that older
mothers are less likely to attend postnatal clinics or may have completed their childbearing
years. The age distribution provides essential context for understanding the vulnerability of
mothers within different age brackets to puerperal sepsis and their ability to access healthcare
services.

17
 5.3.2 Education Level
According to Figure 4.1.2: A pie chart indicating the education level of respondents the data
shows that the majority of respondents (42.86%) had attained secondary education, followed by
38.46% who had reached college or university education. A smaller percentage (18.68%)
reported primary education as their highest level of schooling. This trend indicates that most
respondents had a fair level of literacy, which could positively influence their understanding of
postnatal care practices and the importance of infection prevention. However, the presence of
respondents with only primary education highlights the need for targeted health education
programs to ensure all mothers, regardless of education level, are aware of the risks and
preventive measures associated with puerperal sepsis.

5.3.3 Marital Status

According to Figure 4.1.3: A bar graph on marital status of respondents it indicates that the
majority of respondents (47.25%) were married, which could indicate a higher level of support
during pregnancy and postnatal periods. However, a significant proportion (35.16%) was single,
which may present challenges in accessing consistent support for postnatal care. Respondents
who were widowed (6.59%), divorced (2.20%), or separated (8.79%) collectively accounted for
17.58%, reflecting a minority but potentially vulnerable group.
Understanding marital status is crucial, as it directly influences the availability of emotional,
physical, and financial support, which are all critical in preventing complications like puerperal
sepsis.

5.3.4 Religion
The findings reveal that all respondents identified as Christians, suggesting a homogenous
religious population within the study area. This information is important for tailoring health
education campaigns, as incorporating religious values may enhance the acceptance and
practice of recommended postnatal care measures.

5.3.5 Parity (Number of Children)

According to Figure 4.1.5: A bar graph on Parity distribution of the respondents it demonstrated
that the majority of respondents (35.16%) had two children, reflecting a moderate parity rate
among participants. Additionally, 16.48% of respondents had more than three children,
highlighting a segment with high parity, which may increase the risk of puerperal sepsis due to
repeated exposure to delivery-related complications. Understanding parity is essential for
identifying high-risk groups and ensuring adequate postpartum follow-up for multiparous
mothers.
18
5.3.6 Place of Residence
According to table 4.1.6 a table showing the distribution of respondents depending on their
places of residence. The majority of respondents resided in Emgwen (23.08%), followed by
Mosop (20.88%) and Aldai (18.68%). This data reflects the geographic distribution of mothers
attending postnatal clinics and highlights potential disparities in access to healthcare facilities.
For instance, respondents from Tinderet (8.79%) may face challenges due to its distance from
referral hospitals, emphasizing the need for localized interventions.

5.3.7 Living with a Spouse

According to Figure 4.1.7: A pie chart indicating the number of respondents living with their
spouses. The findings indicate that the majority (67.03%) of respondents lived with their
spouse, which likely provided emotional and financial support during the postnatal period.
However, 32.97% of respondents did not live with their spouse, potentially leaving them
vulnerable to inadequate care and support. This highlights the importance of community-based
programs to support single mothers or those living separately from their spouses.

5.4 SECTION B: LEVEL OF KNOWLEDGE ASSESSMENT

5.4.1 Awareness of Puerperal Sepsis
According to Figure 4.2.1:A pie chart on awareness of Puerperal Sepsis it indicates that while a
majority of respondents had heard of puerperal sepsis, a significant proportion (41.8%) lacked
knowledge of the condition. Table 4.2.1: A table displaying source of information on Puerperal
Sepsis indicated healthcare providers were the primary source of information, which
underscores the importance of healthcare professionals in disseminating critical knowledge on
maternal health. However, the presence of social media and informal networks as sources
highlights the need to ensure accurate information is shared across all platforms.

5.4.2 Knowledge of Signs of Puerperal Sepsis

According to Figure 4.2.2: A bar graph on Knowledge of signs of Puerperal Sepsis the findings
indicate that the majority of respondents (60.4%) were aware of the correct signs of puerperal
sepsis. However, a significant number were unable to differentiate between correct and
incorrect signs, reflecting a knowledge gap that requires focused educational interventions.

19
5.4.3 Experience of Signs of Puerperal Sepsis
According to Figure 4.2.3: A pie chart indicating respondents with experience of signs of
Puerperal Sepsis showed that 18 respondents (19.8%) experienced its signs while 73
respondents (80.2%) did not experience any signs.. These findings emphasize that symptoms of
puerperal sepsis were observed in over a quarter of the respondents who reported symptoms.
Fever and abdominal pain were the most frequently cited symptoms, each reported by 35.29%
of respondents, while 29.41% experienced foul-smelling vaginal discharge as indicated on table
4.2.3 a table indicating signs of Puerperal Sepsis as experienced by respondents this
underscores the importance of early detection and treatment to prevent complications.

5.4.4 Familiarity with Risk Factors of Puerperal Sepsis

Figure 4.2.4: A pie chart showing familiarity with risk factors of Puerperal Sepsis indicated that
41 (45.1%) respondents were familiar with the risk factors associated with puerperal sepsis
while 50 (54.9%) respondents had no idea. For the 41 respondents who were familiar with the
risk factors, The findings reveal that while some respondents were aware of specific risk
factors, knowledge was concentrated on UTI’s and retained products of conception having 35
(85.37%) respondents while Obesity, diabetes, and poor hygiene having 2 respondents (4.88%)
and Age, menopause, and urinary catheterization having 4 (9.76%) respondents . This
highlights the need for targeted educational efforts to improve understanding of all potential
risks associated with puerperal sepsis.

5.4.5 Awareness of Effects of Puerperal Sepsis

According to Figure 4.2.5: A bar graph on awareness of Effects of Puerperal Sepsis
Respondents were asked whether they were aware of the effects of puerperal sepsis after
childbirth 34 (37.4%) respondents responded yes and 57 (62.6%) respondents. For the 34
respondents who were aware, The findings indicate that while over a third of the respondents
had some awareness of the effects of puerperal sepsis, there was a lack of comprehensive
knowledge. Shock was the most commonly cited effect (26.5%), followed by PID (38.2%) and
infertility (32.4%) as indicated on Table 4.2.5:A table on effects of Puerperal signs. This gap in
knowledge could limit the respondents’ ability to fully understand the severity and long-term
consequences of puerperal sepsis.

20
5.5 SECTION C: SOCIO-ECONOMIC FACTORS ASSOCIATED WITH
PUERPERAL SEPSIS
This section assesses the socio-economic factors contributing to the occurrence and
management of puerperal sepsis among mothers. Factors such as employment, income, access
to healthcare, and affordability of services were analyzed. The findings underscore the impact
of economic and social circumstances on maternal health outcomes.

5.5.1 Respondents’ Occupation

Figure 4.3.1: A pie chart on respondent occupation indicated that the majority of respondents
were self-employed that is 41 (45.05%), respondents often running small businesses or
engaging in farming and 33 (36.26%) respondents were employed. A significant proportion17
(18.68%) respondents was unemployed, reflecting limited access to steady income sources.
These findings suggest that economic instability may impact the ability of many respondents to
access healthcare services.

5.5.2 Monthly Income

As indicated in Figure 4.3.2: A bar graph on monthly income The majority of respondents
(40.25%) earned less than Kshs. 10,500 per month, which is below the average living standard
in the area. This limited income highlights economic challenges that could hinder access to
adequate healthcare, balanced diets, and other necessities.

5.5.3 Alternative Sources of Income

As indicated in Figure 4.3.4: A bar chart on alternative sources of income a significant number
of respondents relied on farming that is 35 (38.46%) respondents and 20 (21.98%) respondents
small businesses as secondary sources of income. However, 16(17.58%) respondents depended
on their spouse's income, indicating limited financial independence for some respondents.

5.5.4 Sufficiency of Income to Meet Needs

According to Figure 4.3.4: A pie chart on sufficiency of income to meet needs A majority
(75.82%) reported that their income was insufficient to meet their needs, creating financial
strain that may prevent timely healthcare access and adequate preventive measures for puerperal
sepsis.

21
5.5.5 Figure 4.3.5: Access to a balanced diet
More than half of the respondents (68.13%) could not afford a balanced diet as shown in Figure
4.3.5: A pie chart on access to a balanced diet, a concern given that poor nutrition weakens
immunity and increases susceptibility to infections, including puerperal sepsis.

5.5.6 Proximity to Health Facilities

The findings show that 39.56% of respondents live more than 3 kilometers from the nearest
health facility as shown in Figure 4.3.6: A bar graph on proximity to health facilities,
potentially delaying access to care, particularly in emergencies or for postnatal complications.

5.5.7 Means of Transport to Health Facilities

According to Figure 4.3.6:A pie chart on means of transport to health facility majority of the
respondents relied on walking or public transport reflecting 29 (31.87%) and 40 (43.96%)
respondents respectively, suggesting potential delays in accessing health services, especially
during emergencies. Noting that some of the respondents could not easily access health
facilities due to the proximity to the health facility.

5.5.8 Affordability of Maternal Healthcare Services

According to Figure 4.3.8: A pie chart on affordability of Maternal healthcare services majority
50 (54.95%) respondents indicated that they could not afford these essential services, presenting
a significant barrier to addressing complications like puerperal sepsis. Only 41 (45.05%)
respondents could access maternal health services. Timely healthcare interventions remain
critical to improving maternal outcomes.

5.6 Section D: Hospital-Related Factors Associated with Puerperal Sepsis

This section focuses on healthcare facility-related factors that contribute to the prevalence of
puerperal sepsis. Issues such as availability of maternity hospitals, hygiene practices, and
postnatal care services were analyzed to understand their role in predisposing mothers to
puerperal sepsis.

5.6.1 Availability of Maternity Hospitals

According to Figure 4.4.1: Availability of maternity hospitals the data indicate that most
respondents marking 55 (60.4%) respondents believe there are insufficient maternity hospitals,
potentially leading to overcrowding and delayed access to care.

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5.6.2 Challenges in Health Facilities During Delivery and Postnatal Period
As it is in Figure 4.4.2: A bar graph on Challenges in health facilities during delivery and
postnatal period, staff shortages and overcrowding were the most frequently reported challenges
having 25 (27.5%) respondents and 30 (33%) respondents respectively; highlighting factors that
may compromise care quality and increase infection risks.

5.6.3 Healthcare Providers’ Hand Hygiene Practices

According to Figure 4.4.3: A pie chart on healthcare providers’ and hand hygiene practices,
although 67.1% of respondents reported consistent hand hygiene practices ("always" or "most
of the time"), a significant proportion (32.9%) noted inconsistent adherence, which increases
infection transmission risks.

5.6.4 Cleaning and Disinfection of Hospital Areas

According to Figure 4.4.4: A pie chart on cleaning and disinfection of hospital areas
While over half of the respondents confirmed daily cleaning practices, nearly 46% indicated
cleaning was either infrequent or uncertain, suggesting hygiene lapses in some facilities.

5.6.5 Timing of First Postnatal Clinic Attendance

According to Figure 4.4.5: A bar graph on timing of first postnatal clinic attendance delayed or
missed postnatal visits were reported by 17.6% of respondents, limiting opportunities for timely
screenings or interventions to manage complications.

5.6.6 Screening for Infections During Postnatal Clinic

According to Figure 4.4.6: A pie chart on screening for infections during postnatal clinic a
substantial proportion (73.7%) reported inconsistent or no infection screening, revealing missed
opportunities for early detection of conditions like puerperal sepsis.

5.6.7 Postnatal Symptoms Experienced

According to Figure 4.4.7: A pie chart on postnatal symptoms experienced while some
respondents reported symptoms linked to puerperal sepsis, most (60.4%) did not experience any
symptoms, illustrating diverse postnatal experiences.

5.6.8 Awareness of Puerperal Sepsis Cases in the Community

According to Figure 4.4.8: A pie chart on awareness of Puerperal Sepsis in the community, the
findings suggest that puerperal sepsis is a recognized concern in the community, with 57.2% of
respondents aware of its occurrence. This awareness could be leveraged for community health
education and preventive strategies.
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CHAPTER SIX: CONCLUSION AND RECOMMENDATIONS.

CONCLUSION
This chapter examined various factors contributing to puerperal sepsis, focusing on
demographic information, knowledge of puerperal sepsis, socio-economic factors, and
hospital-related issues. The findings across each section underscore critical gaps and areas for
improvement in maternal healthcare that directly impact the incidence and outcomes of
puerperal sepsis.

1. Demographic Factors:
The demographic data reveal a diverse sample of women, with varying levels of
education, marital status, and socio-economic status. However, a significant portion of
the respondents were either unaware or had limited knowledge about puerperal sepsis
and its associated risk factors. This gap highlights the need for targeted educational
initiatives.
2. Knowledge of Puerperal Sepsis:
The level of knowledge about puerperal sepsis was found to be insufficient. Many
respondents were unaware of the signs, risk factors, and potential effects of the
condition. While a considerable number knew what puerperal sepsis is, the sources of
their information were not always reliable or sufficient. This lack of awareness can
delay diagnosis and increase vulnerability to complications.
3. Socio-Economic Factors:
Socio-economic factors such as income level, employment status, and access to health
services play a significant role in shaping maternal health outcomes. Many
respondents reported financial constraints that hindered their ability to access
balanced diets and timely maternal healthcare. Additionally, the distance to healthcare
facilities and reliance on inconsistent transportation also posed significant barriers.
4. Hospital-Related Factors:
Hospital-related factors emerged as critical contributors to puerperal sepsis risk.
These included staff shortages, overcrowding, inconsistent infection control practices
(such as hand hygiene), inadequate cleaning of hospital facilities, and lack of routine
infection screenings. The respondents' experiences highlighted how these factors
increase the likelihood of post-delivery infections, including puerperal sepsis.

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RECOMMENDATIONS
Based on the findings, the following recommendations are made to address the identified
gaps and reduce the risk of puerperal sepsis:
1. Enhance Maternal Health Education:
Public health campaigns should be launched to educate women about the signs, risk
factors, and prevention of puerperal sepsis. Healthcare providers should also engage
in proactive counseling during antenatal and postnatal visits to raise awareness about
the condition.
2. Improve Access to Healthcare Services:
The government and local authorities should invest in building more accessible
healthcare facilities, particularly in rural and underserved areas. Mobile clinics and
outreach programs can help bridge the gap where healthcare facilities are distant.
3. Strengthen Infection Control Measures in Hospitals:
Healthcare facilities must adopt strict infection control protocols, ensuring consistent
hand hygiene practices by staff and regular cleaning and disinfection of hospital
rooms, labor wards, and common areas. Training healthcare providers on infection
prevention and control should be prioritized.
4. Improve Postnatal Care and Screening:
Timely postnatal visits should be encouraged, and routine screening for infections
should be implemented across all health facilities. Healthcare providers should ensure
that every mother attends postnatal clinics within the recommended timeframe (0–6
weeks) for proper monitoring and early detection of infections.
5. Address Socio-Economic Barriers to Healthcare:
Financial support mechanisms, such as subsidies or insurance schemes, should be
introduced to ensure that all women can access quality maternal healthcare services,
including antenatal and postnatal care. Additionally, efforts should be made to ensure
that women can afford a balanced diet, especially during the postpartum period, to
improve their overall health and immune system.
6. Increase Staff and Resources in Healthcare Facilities:
Governments and health organizations should allocate more resources to increase the
number of trained healthcare professionals, particularly in maternal and newborn care.
Addressing staff shortages and improving the working conditions in healthcare
facilities will help reduce overcrowding and improve care quality.

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