Determinants Of Utilization Of Maternal And Neonatal Healthcare Services By Mothers In Embakasi Sub-County, Nairobi, Kenya

Abstract

This study sought to establish the determinants of utilization of maternal and neonatal health care services in Embakasi sub-county. The study focused on determinants of utilization of three aspects of maternal and neonatal health care services in Embakasi sub-county, namely number of antenatal care visits, skilled assistance during delivery and post-partum care for mother and newborn after delivery. Low levels of education of mothers, long waiting time for services, lack of privacy in service delivery and poor service integration are the key factors behind the low utilization of maternal and neonatal health care services in public health facilities in Embakasi sub-county. The adverse consequences of low utilization of maternal and neonatal health services are well documented in literature. They include high maternal and infant deaths, increased maternal related injuries and disabilities, high fertility due to unintended childbearing and disempowerment of women against access to sexual and reproductive health rights. Kenya has one of the highest maternal death rates in the world at 448 per 100,000 live births above the MDG target of 147 per 100,000 by 2015. Embakasi sub-county, in particular has frequently experienced maternal and newborn deaths despite the government of Kenya initiating a policy of free maternity services (FMS) in all public facilities in June 2013. The purpose of this study was to establish the determinants of utilization of maternal and neonatal health care in Embakasi sub-county. The level of utilization of maternal and neonatal health care services in the public health facilities in Embakasi were established. The study design employed was descriptive survey design, which was conducted among women seeking maternal and neonatal health care services in 4 public health facilities in the area. The target population was 1,870 mothers. A sample of 317 mothers for the study was obtained guided by Krejcie and Morgan table for determining sample size from a defined population. One structured questionnaire was used to obtain data from study participants and a structured interview guide was used to collect additional information from one health care personnel from each facility. The analysis of quantitative data was done using Statistical Package for Social Sciences while qualitative data was analyzed thematically and the findings presented in tables. The findings of this study showed that utilization of maternal and neonatal health care services is influenced by education level of mothers, waiting time for services, privacy in health care delivery and service integration. The study recommended that the hospitals should improve on the privacy of the sections of the facilities where MCH services are offered as well and increase in education of mothers and community sensitization campaigns as means of accelerating uptake of maternal health services. The government and policy makers should also employ more staff to improve health worker to client ratio with an aim of reducing the waiting time for services. Finally, the study recommended an improvement in service integration to ensure all MCH services are provided under one roof