Determinants of safe delivery practices among mothers in Lunza division of Butere District, Kenya
Women of reproductive age play a key role in the procreation and passing on of the torch of life from generation to generation since time immemorial. This is particularly achieved through the process of child delivery. Child delivery takes place in various situations that include: hospital or health facility environment, home environment with skilled midwifery personnel and home delivery with non-skilled personnel. The purpose of this study is to document how independent variables; education level, age, distance/ Accessibility, social - cultural beliefs and economic status of a mother would influence choice for a skilled delivery. The study was further to investigate if there could be other reasons as to why a majority of mothers having accessed antennal clinics and educated on the importance of skilled deliveries still end up delivering in the hands of untrained community persons. This study was designed to document the influence of educational level, income level, sociocultural factors and accessibility of health facilities of the respondents in relation to their seeking skilled deliveries. The study was anchored on a descriptive survey design. Primary data was collected using both open and close ended questionnaires administered through an interview particularly for the target reproductive mothers. The target sample size consisted of 110 out of eligible 16,243 reproductive active women sampled from a Lunza Division and 20 health attendants sampled from 59 Health Service Providers in the district. A sample size was determined using Nassiuma's formula. Pretesting of the research instruments was done to measure the validity and reliability of the instruments. Reliability of the research instrument was ascertained using Pearson correlation coefficient which yielded value of r = 0.75. The data collected was analyzed using statistical package for social scientists progamme. Descriptive statistics and Pearson correlation was used to get the degree of relationship between the independent and dependent variables. The data was presented in frequency tables, percentages and cross tabulations. The findings indicated that education levels of respondents played a key role in determining utilization of skilled maternal delivery services. Socio-cultural factors like traditions, cultural and religious beliefs negatively influenced skilled maternal delivery. Income levels of respondents negatively influenced skilled maternal delivery services offered by hospitals in Lunza Division of Butere District and results revealed that distance and income corresponded negatively to attendance of antenatal clinics and post natal clinics. Distance was a major factor negatively influencing accessibility of skilled maternal delivery services. The recommendations made following the study include: reproductive active women should be educated on benefits of skilled deliveries; investment in human resources including a cadre of skilled midwives and birth attendants who can be present before, during and after birth; having in place educational and sensitization activities, such as, conferences, seminars and workshops; publication of training manuals, case studies and best practices, and provision of technical and financial assistance should also be conducted and the Government should ensure that the health systems are strengthened with emphasis on ensuring access and referral networks that do not imply major opportunity costs for women to access. There is need for high level of political commitment towards improving maternal health. The findings of this study may be useful to the Ministry of Health, academicians, researchers and other stakeholders in Ministry of Health for their improvement of policies and practice on skilled maternal delivery.