Factors influencing utilisation of maternal health care services in Nyanza province, Kenya
Abstract
The study is based on data drawn from the 1993 Kenya Demographic and Health Survey
(KDHS). An analytical model was adapted from Kroeger (1983) to act as a guideline to the
study. Cross tabulations were used to establish differentials in use of maternal health care
services. Logistic regression analysis was used to analyse the effects of the independent
variables on use of different maternal health care services.
The results obtained show that for the births in the study, there is a general low level of
utilisation of maternal health care services in Nyanza province. In addition, there are significant
differentials in the use of maternal health care services by the study population. Factors that had
significant influence on the uptake of tetanus toxoid vaccinations were paternal education and
ever use of family planning. The uptake of tetanus vaccination was positively and significantly
,associated with paternal education. Women who had ever used modem methods were also most
likely to get the vaccine. Timing of the first antenatal check was associated with whether a
woman earned cash for work or not. There was a significant association between choice of
prenatal care provider and the each of the following: maternal education, paternal education,
household economic status and the number of children ever born. The type of place of delivery
and assistance during delivery were significantly associated with maternal and paternal
education, household economic status, earning cash, maternal age and total children ever born.
Other factors that were associated with the type of place and assistance during delivery were
number of antenatal visits, scale of antenatal care, timing of antenatal visits and type of place of
residence.
Household economic status and paternal education was each significantly associated with the
choice of a prenatal care provider. Higher status households and having at least secondary
education led to greater likelihood of seeking professional antenatal care. Timing of the first
antenatal visit was determined by earning cash for work, whereby mothers who earned had
greater chances of seeking early prenatal care. The other factor was maternal education, so that
the higher the level of education, the greater the chances of early onset of antenatal care.
The choice of place of delivery and assistance received during delivery were each determined by
household economic status, type of place of residence, ever use of family planning, paternal
education, the timing of antenatal visits and the number of clinic visits made.
Overall, the study found that differences in utilisation of maternal health care services in Nyanza
province were mainly as a result of socio-economic factors rather than demographic factors.
Arising from the results of the study, several recommendations have been made. The study found
that majority of births, their mothers got adequate antenatal care. However over 60 per cent of
the births were delivered at home. The study therefore strongly recommends that coverage of
health facilities offering delivery services should be increased. Studies should also be conducted
to establish the reasons for the discrepancy. Secondly, community education on the importance
of using maternity health care services is necessary. Moreover, barriers to access in rural areas
should be eliminated. Lastly, the study recommends that qualitative research should be done to
explain some of the patterns of utilisation observed, since the study was only able to give a
quantitative approach. Specifically, it would be useful to know why women in Nyanza begin
antenatal clinics late, go for only a few clinic checks and why they prefer to deliver at home.
Citation
M.Sc (Population Studies) Thesis 2000Sponsorhip
University of NairobiPublisher
Faculty of Arts, University of Nairobi
Description
Master of Arts Thesis