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dc.contributor.authorNamusonge, Lucy Natecho
dc.date.accessioned2018-06-12T09:57:08Z
dc.date.available2018-06-12T09:57:08Z
dc.date.issued2016-06
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/18450
dc.descriptionA thesis submitted in partial fulfilment of the requirements for award of the degree of master of public health (Reproductive Health) in the school of public health of Kenyatta University, June 2016en_US
dc.description.abstractMinority of births in Sub-Saharan Africa are conducted by Skilled Birth Attendants (SBAs). Having the highest world maternal mortality ratios and most deaths being associated with lack of trained supervision at delivery, changing delivery practices is a major priority in this region. Utilization of Skilled Birth Attendants (SBAs) may contribute to reducing Maternal Mortality Rate (MMR). While approximately 95.5% of women giving birth receive some antenatal care, 39% of Kenyan women deliver at home especially in rural areas. Kakamega County has low facility deliveries at 48.6% compared to the national average of 61%, this magnitude present a key challenge to improvement in maternal survival. Pregnant women in Kakamega County have varied reasons for delivering at home where deliveries are conducted by unskilled birth attendants. The study was motivated by the poor maternal indicators and low utilization of skilled birth attendance in Kakamega County despite interventions to address the problem. This study attempted to identify reasons to persistent utilization of unskilled birth attendance by women in Kakamega County. It was a descriptive cross-sectional study utilizing quantitative and qualitative approaches targeting postnatal mothers with children aged less than six months who delivered without skilled attendance. Quantitative data was collected through household interviews of eligible women using structured questionnaire and qualitative data collected using Focused Group Discussions (FGDs). All the analysis was done using Statistical Package for Social Sciences (SPSS v. 20.0). Chi square (X2) was used to assess if there was significant relationship or association between independent variables and utilization of Unskilled Birth Attendance (UBA). Pearson product-moment correlation coefficient was used to measure the strength of the linear relationship between the dependent and independent variables under study. The results showed antenatal attendance rate of 92.7%. Low knowledge, socio-cultural factors and health system factors favoured utilization of UBA. Knowledge factors found to enhance utilization of UBAs in the study area were: knowledge on danger signs during labour and delivery (r= 0.430 X2=36.104, P= 0.0001), knowledge on danger signs during post natal period (r=0.466, X2=37.403, P=0.0001) and knowledge on individual birth plan (r=0.374, X2=23.67, P=0.0001). Socio-cultural factors on uptake of unskilled birth attendance were influenced by receipt of support from partner or significant others (r= 0.964, X2=23.210, P=0.00), marital status (r= 0.720, X2=36.104, P=0.00), education level (r=0.562, X2=28.360, P=0.003) and decision maker on choice of place of delivery (r=0.504, X2=29.42, P=0.0001). Health system factors influencing utilization of unskilled birth attendance were perception towards health facility staff (r=0.287, X2=20.46, P=0.000), availability of service (r=0.341, X2=18.13, P=0.006) and availability of 24 hour service (r=-0.249, X2=8.764, P=0.005). There is need to equip women with knowledge on pregnancy, labour and delivery and postnatal periods and ensuring that health care providers are kind and culturally sensitive to the needs of clients hence scaling up utilization of skilled birth attendance. Birth preparedness should be advocated for every pregnant woman. The information generated from this study will be utilized by policy makers leading to appropriate interventions or strategies which can reduce the number of home deliveries and maternal deathsen_US
dc.description.sponsorshipKenyatta Universityen_US
dc.language.isoenen_US
dc.titleWomen’s persistent utilization of unskilled birth attendance: a study of mothers in Kakamega County, Kenyaen_US
dc.typeThesisen_US


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