Factors Associated With Continuum of Maternal Health Care in Kenya

Abstract

This study focuses on uptake of maternal health care among pregnant women that is adequate antenatal care services use, health facility delivery and timely postnatal care of the mother. The aim of the study was to determine factors associated with the continuum of maternal health care in Kenya. It examined the predisposing, enabling and need factors related with the use of maternal health care services. The study used data from Kenya Demographic and Health Survey 2014 and focused on women in the reproductive age 15-49 years with a live birth in the five years preceding the survey. To determine factors associated with the use of adequate antenatal care (attending one ANC visit within the first three months of pregnancy and at least four ANC visits throughout the pregnancy), delivery in the health facility and timely postpartum care (not more than 48 hours after delivery) logistic regression model was used. Education, household wealth, health insurance and parity were found to determine uptake of maternal health care in Kenya. Women with higher education, women in the rich wealth quintile, women covered by health insurance and women with low parity had significantly higher odds for adequate ANC. Women with above secondary education, married women, women who live in the urban areas, rich wealth quintile women, employed women, women with only one child and women who received adequate ANC were more common in health facility delivery. Receiving timely postnatal care services is significantly associated with women in the rich wealth quintile, women’s level of education, women with low parity, women who received ANC and women who delivered in a health facility. From the study, we can see a link in the three outcomes, from the multivariate analysis, through a set of common factors. Women’s education is the common predisposing factor, enabling factor is wealth and residence and parity is the need factor. Education intervention approaches and health promotion should be provided in regions with low literacy levels. It is also important for government to increase household wealth in order reduce poverty and also to achieve maternal health coverage. And finally, maternal mothers should be encouraged to effectively attend postnatal health care services. Ethnographic and qualitative studies should be undertaken to help understand how cultural factors affects maternal health utilization.