DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20214988

Assessing individual factors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya.

Christine B. Arero, Margaret N. Keraka, Shadrack Y. Ayieko, Geoffrey M. Okari, Vincent O. Matoke

Abstract


Background: Globally, about 295,000 maternal deaths occurred in 2017 with Sub-Saharan Africa and Asia accounting for 86%. Sub-Saharan Africa alone accounted for nearly two-thirds. The rate of skilled birth attendant in Sub-African region stood at 59%. Three quarters of neonatal and maternal deaths occur outside hospital settings. Currently, the rate of maternal mortality in Kenya stands at 362 per 100,000 live births. Despite the deliberate government interventions to increase hospital deliveries, still a significant number of women deliver at home. The objective of this study was to assess the individual actors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya. 

Methods: This was a cross-sectional descriptive study adopting both quantitative and qualitative data collection methods. A total of 416 postnatal women were systematically sampled from households at a predetermined interval of four. Key informants interviews and focused group discussions provided additional qualitative data.

Results: Approximately 56.7% of postnatal women in Marsabit County delivered in health facilities. Most individual factors such as decision maker (p=0.031), myths and misconceptions (p=0.025), reduction of complications (p=0.001), hospital delivery time consuming (p=0.023) and possession of medical insurance (p=0.001) were significantly associated with choice of place of delivery. 

Conclusions: Approximately 6 out 10 deliveries occur at health facilities in Marsabit County. Individual factors significantly influenced choice of place of delivery. There is need for the ministry of health, County Government of Marsabit and relevant stakeholders to demystify myths and misconceptions about hospital deliveries, scale up awareness on availability of Linda Mama medical cover for pregnant women to ensure easy access of hospital delivery services.  


Keywords


Utilization, Postnatal women, Individual factors, Skilled delivery

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References


Trends in Maternal Mortality: 2000 to 2017. Available at: https://www.who.int/reproductive health/publications/maternal-mortality-2000-2017/en/. Accessed on 20 October 2021.

Njuguna J, Kamau N, Muruka C. Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya. BMC Health Serv Res. 2017;14:51-9.

Moindi R, Ngari M, Nyambati V, Mbakaya C. Why mothers still deliver at home: understanding factors associated with home deliveries and cultural practices in rural coastal Kenya, a cross-section study. BMC Public Health. 2016;16:114.

Status of implementation of free maternity services (FMS) program in the devolved health system in Kenya. Available at: http://publications.universal health2030.org/uploads/free_maternal_health_services_report_feb_2015_final1_doc_.pdf. Accessed on 20 October 2021.

Kenya demographic and health survey 2014. Available at: https://dhsprogram.com/pubs/pdf/ fr308/fr308.pdf. Accessed on 20 October 2021.

Njuki R, Abuya T, Kimani J, Kanya L, Korongo A, Mukanya C, Bracke P, Bellows B, Warren CE. Does a voucher program improve reproductive health service delivery and access in Kenya? BMC Health Serv Res. 2015;15:206.

Mutinda M. Factors influencing unskilled delivery in Kenya. Available at: http://erepository.uonbi.ac.ke/ bitstream/handle/11295/103036/Mulinge_Factors%20Influencing%20Unskilled%20Delivery%20In%20Kenya.pdf?sequence=1&isAllowed=y. Accessed on 20 October 2021.

Orit A, Erika L, Halima M, Fetene N, Bradley EA. patient-centred understanding of the referral system in Ethiopian primary healthcare units. PLoS One. 2015;10(10):1-10.

Nigatu AM, Gelaye KA. Factors associated with the preference of institutional delivery after antenatal care attendance in Northwest Ethiopia. BMC Health Serv Res. 2019;19(1):1-9.

Dickson KS, Adde KS, Amu H. What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana. Int J Reprod Med. 2016;2016:7203980.

Belda SS, Gebremariam MB. Birth preparedness, complication readiness and other determinants of place of delivery among mothers in Goba District, Bale Zone, South East Ethiopia. BMC Pregan Childbirth. 2016;16(1):1-12.

Kelel, HU, Dasa TT. Factors influencing women's choice of place of child delivery in rural Wondo Genet District, Southern Ethiopia. BMC Pregan Childbirth. 2019;17(1):1-10.

Ekwochi U, Osuorah CD, Ndu IK, Ifediora C, Asinobi IN, Eke CB. Food taboos and myths in South Eastern Nigeria: The belief and practice of mothers in the region. J Ethnobiol Ethnomed. 2016;12:7.

Sahoo J, Singh SV, Gupta VK, Garg S, Kishore J. Do socio-demographic factors still predict the choice of place of delivery: A cross-sectional study in rural North India. J Epidemiol Global Health. 2015;5(4):S27-34.

Caulfield T, Kitui J, Lewis S, Davey G. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009. BMC Pregnancy Childbirth. 2013;13:40.

Gildner TE, Thayer ZM. Birth plan alterations among American women in response to COVID-19. Health Expect. 2020;23(4):969-71.

Najafi-Sharjabad F, Keshavarz P, Moradian Z. Survey on the prevalence and influencing factors for choosing Normal vaginal delivery among pregnant women in Bushehr City, 2015. Commu Health J. 2018;11(1):20-9.

Bhattacharyya S, Srivastava A, Roy R, Avan BI. Factors influencing women’s preference for health facility deliveries in Jharkhand state, India: a cross sectional analysis. BMC Pregn Childbirth. 2016; 16(1):1-9.

Karanja S, Gichuki R, Igunza P, Muhula S, Ofware P, Lesiamon J, Ojakaa D. Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya. BMC Pregn Childbirth. 2019;18(1):1-11.

Oluoch-Aridi J, Adam MB, Wafula F, K'okwaro G. Eliciting women's preferences for place of child birth at a peri-urban setting in Nairobi, Kenya: A discrete choice experiment. PLoS One. 2020;15(12):e0242149.

Nesbitt RC, Lohela TJ, Soremekun S, Vesel L, Manu A, Okyere E, Grundy C, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR, Gabrysch S. The influence of distance and quality of care on place of delivery in rural Ghana. Sci Rep. 2016;6:30291.

Gudu W, Addo B. Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study. BMC Pregn Childbirth. 2017;7(1):1-10.