Utilization of individual birth plan during pregnancy among women aged 18-49 years in Kisau Division Makueni County, Kenya
Ndeto, John Kyunguti
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Maternal and prenatal mortalities and morbidities have remained a challenge in many developing countries like Kenya, despite the fact that the causes are preventable if not avoidable. Utilization of birth plan in preparation for childbirth is one of the strategies utilized by women in middle and low-income countries to reduce maternal and prenatal mortalities. However, the relationship between utilization of individual birth plan and maternal and prenatal mortalities in developing countries has been inadequately established. Complications related pregnancy and childbirth cannot be reliably and accurately predicted, therefore, this calls for implementation of strategies to solve these problems and especially in the rural areas of developing countries where the situation is most dire. The study aimed at examining the utilization of individual birth plan during pregnancy among women in Kisau division, Makueni County, Kenya. Specifically, the study aimed to determine the proportion of post-natal women who utilized individual birth plan in their last delivery, to establish the demographic characteristics, socio-cultural and healthcare providers’ factors that influence individual birth plan utilization during pregnancy among women in Kisau division. This was a descriptive cross-sectional study that utilized both qualitative and quantitative approaches involving 326 women aged 18-49 who were had delivered 9 months preceding the survey. Systematic random sampling technique was used to recruit the study participants. Data was collected using a pretested and structured interviewer administered questionnaire for women aged 18 -49 years and focus group discussion for healthcare providers.Statistical Package for Social Sciences (SPSS) program version 20 was used for data management and statistical analysis. The study established that 157 of the 326 women interviewed had utilized an individual birth plan. Hence, overall proportion of users of IBP in the study population was 48.2% (95% CI (42.7%-53.6%). Women of the age bracket 28 to 37 years were two times more likely to utilize IBP compared to those of the older age (OR=2.108, p=0.005) while having attended school was a significant factor in the utilization of individual birth plan (OR=12.828, p<0.001). A married woman had a 2.2-fold increment in the likelihood of utilizing the IBP as opposed to her counterparts who were not married (OR=2.20, p=0.001).Despite the high level of ANC attendance IBP utilization is low in the study area. There exists a gap between knowledge and practice of utilization of individual birth plan among women of reproductive age. Moreover, heavy workload to the health care providers is an impediment to the provision of adequate information on IBP to women of reproductive age. Therefore, there is need to increase the patient-healthcare provider ratio in the health facilities. The Ministry of Health should encourage the utilization of individual birth plan among women of reproductive age by use of satisfied clients. In addition antenatal care program stakeholders should focus on young women of reproductive age (<27 years) so as to increase IBP utilization. Lastly healthcare providers should adopt IBP as a tool in ANC care provision and discuss its utilization with women of reproductive age to allay any fears and address the related perceptions as this will go a long way in enabling the realization of United Nations Sustainable Development Goal 3.