ArticleBMC pregnancy and childbirth2026
Knowledge, attitudes, and practices of nurses and midwives on maternity triage in Rwanda: a cross-sectional study in two urban hospitals.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTimely and appropriate care for expectant mothers and newborns depend on effective maternity triage. However, the level of understanding and application of maternity triage among nurses and midwives in Rwanda remains unclear. The knowledge, attitude, and practice (KAP) of nurses and midwives on maternity triage were evaluated in this study, and factors influencing adherence to triage protocols were investigated.
methodsA cross-sectional, quantitative study was conducted among 83 nurses and midwives working in the maternity units of Kibagabaga Level II Teaching Hospital and Muhima District Hospital in Kigali, Rwanda. Participants were recruited using proportional stratified random sampling derived from a calculated representative sample size. Data were collected using a structured, self-administered questionnaire validated to assess knowledge, attitude, and practice (KAP). Descriptive statistics were used to summarize findings. Chi-square tests and binary logistic regression were used to assess associations between KAP levels and sociodemographic variables.
resultsOnly 31.3% of participants demonstrated adequate knowledge, while 83.1% demonstrated a positive attitude, and 94.0% reported good practice. Practice subdomain analysis demonstrated good performance in triage frequency (96.4%), assessment and categorization (94.0%), and action and clinical response (75.9%). Among the three attitude sub-domains, perceived importance (94.0%) and commitment to implementation (92.8%) showed high levels of positivity, whereas perceived barriers had a notably lower score (45.8%). Knowledge was significantly associated with gender (p = 0.019) and hospital (p = 0.041). Male participants were more likely than females to have adequate knowledge, as were those from Kibagabaga Level II Teaching Hospital compared to Muhima. While attitude showed no significant association with sociodemographic characteristics, it was significantly associated with practice (p = 0.002), with a positive attitude increasing the likelihood of good practice.
conclusionThis study highlights a significant disparity between high reported practice in maternity triage and low knowledge of theory, with notable differences related to hospital setting and gender. Health systems must transition from didactic training to competency-based simulations and conduct regular clinical audits to verify competence beyond self-reporting, thereby closing this gap. Additionally, tailored mentorship programs that especially address knowledge gaps among female providers and personnel in non-teaching facilities should be used to leverage positive provider attitudes in interventions. To provide reliable, excellent emergency obstetric treatment, these evidence-based measures are crucial.
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