Factors Infuencing Place of Delivery in Kenya: A Multilevel Analysis.

Abstract

Background:Maternal mortality in Kenya increased from 380/100000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990s. We use the 2014 Kenya Demographic and Health Survey data to describe the factors that determine where women deliver in Kenya and to explore reasons given for home delivery. Methods:Data from the 2014 Kenya demographic and health survey was used to nd out the factors associated with the place of delivery among women who had a live birth during ve years preceding the survey. Owing to the fact that the data’s structure is nested, multilevel logistic regression analysis has been employed to a nationally representative sample of 20354 women who are nested within 1612 communities. Results:The outcome showed that woman’s level of education, place of residence, wealth index, birth order number, distance to the health facility, and antenatal care visits were signi cantly associated with place of delivery. The random e ects depicted that the variation in institutional delivery service utilization between communities was signi cant statistically. Conclusion:In this study it was found out that factors like place of residence, mother’s educational level, wealth index, distance to health facility, and number of antenatal care visits (ANC) were found to be having signi cant in uence on place of delivery. It was also established that both community and household levels random intercepts (variances) were large and statistically signi cant indicating di erences that are considerable between communities and between households in the tendency of women’s use of health institutions for delivery services. It was also found out that there was existence of unobserved signi cant variability between communities and between households further to the in uence of the measured predictors or rather factors.