Effects of community-based skilled birth attendant services on maternal health in Murang'a South District

Abstract

Background: Despite various national and international initiatives to improve maternal health, more than half a million women from developing countries die each year from complications related to pregnancy and childbirth (World Health Organization, 2005). The maternal mortality ratio in Kenya is 414 per 100,000 live births with only 42% of births assisted by a skilled birth attendant. Objective: Despite efforts to advocate for skilled attendants during childbirth in Kenya, patterns of behaviour have remained static for over a decade (KDHS 1998 and 2003). The purpose of this study was to assess the effects of community based skilled birth attendant services on maternal health in Murang'a South district. Methodology: This was qualitative field study that assessed the effects of community based skilled birth attendant services on maternal health during pregnancy, childbirth and immediately after birth. Focus group discussions (FGD), Key informants and in-depth interviews were used to collect data from women respondents, FGD participants and health service providers as key informants. Results: This study found that acceptability of community based skilled birth attendant services in Murang'a South district was high. The study also found that the initiative was undermined by inadequate administrative support as well as lack of a budgetary allocation from the government. Conclusion: Community based skilled birth attendant services filled a significant gap in maternal health care in Murang'a South district The demand for quality communitybased maternal health services was undeniable, but systemic issues compromise the efficacy of the initiative. Although the findings of this study showed community based skilled birth attendant services had an effect on maternal health, there is need for more detailed quantitative research and analysis to reinforce these findings. The support for community midwifery, among stakeholders, indicates that the initiative, with certain revisions, is appropriate for scaling-up and//or replication in other parts ofthe country.