Factors Influencing Unskilled Delivery in Kenya

Abstract

Maternal deaths are still a big problem in the developing nations when compared to the developed world, at 437 deaths and 12 deaths per 100,000 live births respectively (PRB, 2016). Kenya has had no substantial reduction in maternal deaths in the last decade. The Kenya Demographic and Health Surveys reports of 2008-09 and 2014 reported maternal mortality ratios (MMR) of 488 and 362 deaths per hundred thousand live births respectively (KNBS & ICF Macro, 2010; KNBS&ICF International, 2015). Findings for developing world have found that use of skilled care for ANC and delivery services can greatly bring down the number of maternal deaths (Gabrysch and Campbell, 2009; Edmonds, 2010). Why are pregnant mothers seeking ANC services in high numbers while the same high numbers are not delivering under the care of skilled birth attendance? Why does this gap still exist, resulting into high numbers of maternal deaths? The study seeks to determine factors that influence the use of unskilled birth attendance during delivery in Kenya The main objective of the study is to determine the factors associated with use of unskilled delivery in Kenya. Specific objectives are: To establish demographic; socio-economic; health service and socio-cultural factors influencing use of unskilled delivery in Kenya. Understanding t individual characteristics of women who use unskilled birth attendance is important to inform key priority areas for policy change and interventions especially specific to such groups of women. The data of the study was obtained from the2008-09 Kenya Demographic and Health Survey. The study was conceptualized within the “attitudes, social influence and self-efficacy (ASE) model”, adapted from Amooti-Kaguna and Nuwaha (2000). Methods of data analysis employed were descriptive statistics, cross tabulations and binary logistic regression. The study variables analysed were: maternal age, birth order, maternal education, wealth index, place of residence, number of ANC visits, ever use of contraceptives, and region of residence. The bivariate analysis results showed that all the variables were significantly ix associated with the use of unskilled delivery. However, the logistic regression results showed that only maternal age did not have effect on the use of unskilled delivery. The study recommends the governments and other non-state actors to ensure girls stay longer in school to complete their secondary education; the County Governments in Kenya to ensure full implementation of the Community Health Strategy and have the Community Units functional and sustainable and conduct more qualitative research to establish cultural barriers hindering access of delivery services by mothers.