Determinants Of Non-Utilization Of Skilled Health Assistance During Delivery In Kenya

Abstract

The use of maternal health care services is an effective means for reducing the risk of maternal morbidity and mortality, especially in developing countries where the general health status of women is poor. This study aims to analyze the determinants of non-utilization of skilled health assistance during delivery in Kenya among women of reproductive age. The study used data from 2008-09 and 2014 KDHS for women with a last birth in the five years preceding the survey. Descriptive statistics and multivariate logistic regression methods of analysis were used to determine the association and significance of independent variables on non-utilization of skilled health birth attendance during delivery among women of reproductive age. The dependent variable was whether a woman used skilled health attendance during delivery in the five years preceding each survey. The main independent variables were: age of the woman, parity, marital status, level of education, wealth index, place of residence (urban-rural), religion, region of the country and use of antenatal care by the woman. The results show a notable decline in the level of non-utilization of skilled health assistance during delivery from the year 2008/09 to the year 2014. The independent variables were found to be significantly associated with non-utilization of skilled health assistance during delivery in the five years preceding both 2008/09 and 2014 surveys. In the five years preceding the 2008/09 survey, the odds of non-utilization of skilled health assistance during delivery were lower for women of age 25 and above, women with high levels of education, richer women, women in urban areas, those in Central region and women who attended antenatal health. But the odds were higher for women with high parity, women in the rural areas, non-Catholic women and women in the remaining regions. In the five years preceding the 2014 survey, the odds of non-utilization of skilled health assistance during delivery were higher for older women, women of parity 4 and higher, married and formerly married women, rural women, women of Muslim faith and women in Western and Rift Valley regions but lower for women education level of primary and above, those of middle and rich wealth index, protestant and Catholic women and women from Central, Nyanza and North Eastern regions.Therefore effort is needed to educate the general public on the importance of maternal health care services, focusing on the social structures that deter women from utilizing skilled health assistance during delivery to create and strengthen conditions that encourage the use. There should be deliberate improvement on access to health care particularly in the rural areas so as to improve on the use of skilled health attendance at delivery by the women. Policies to sustain and improve on the noted gains should be vi implemented. Finally research should focus on the noted increase of younger women of age 34 years and below not utilizing skilled assistance during delivery. TABLE OF