Utilization of Unskilled Birth Attendants’ Services among Women in Mbirikani Division, Loitokitok District of Kajiado County, Kenya
Utilization of unskilled birth attendants’ (UBA) services by women in Mbirikani division of Kajiado County was studied. The study described the proportion of women who utilized UBA services, determined factors that influenced the utilization, established the levels of awareness and acceptance of the 2007 RH policy action on TBAs and suggested ways to engage UBAs in RH. 328 women, 15 TBAs and 3 key informants were sampled in the cross sectional study. Questionnaires and interviews were used to collect data. TBAs’ activities over four weeks were recorded. The study area was selected purposively. Mbirikani Division was clustered into four sub-locations from which women were selected by simple random sampling. Purposive sampling of TBAs and key informants was employed. Data was analyzed by Statistical Package for the Social Sciences (SPSS) and presented in charts, graphs and tables. Statistical tests and qualitative inference were used to interpret the results. 84.1% (276) of women utilized the services at least once. Utilization of UBA services was highest during delivery at 68%, was 49% for antenatal care (ANC) and 53% for postnatal care (PNC). TBAs offered ANC, delivery, PNC and family planning (FP) services. Utilization of UBA services at least once was higher among uneducated women, those who lived more than 1 hour from a health facility, had more than six children and were aged 35-49 years, Odds ratio (OR) 10.46, 4.21, 3.25 and 2.69 respectively. Women’s education, distance to the health facility and age were significantly associated to ANC, delivery and PNC services. The number of children was associated with delivery and PNC services’ utilization, marital status with ANC services while income level with PNC services, p values <0.05. TBAs’ factors did not affect ANC. TBAs’ age and experience affected women’s utilization of delivery services while age affected utilization of PNC services (p > 0.05) both with negative correlation. 20% of women and 73% of TBAs were aware of RH policy on TBAs, 62% and 67% rejected the policy respectively. Allowing UBAs to distribute health care supplies and drugs, assist in delivery preparedness, refer and assist women with house chores were some of the suggested ways to utilize UBAs. Majority of women were utilizing UBA services despite policy actions in RH, largely due to low literacy levels and cultural influence. The study recommended sensitization and promotion of skilled RH services among women and TBAs; campaigning against negative culture, improve literacy levels among women and insecurity from wild life. Safe utilization of UBAs and how best to eliminate the barriers in poor rural settings should be carried out.