Browsing by Author "Kabue, Priscillah Njeri"

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    Determinants of Utilization of Hospital Delivery among Post-Natal Mothers in Thika and Kangundo Hospitals, Kenya
    (Kenyatta University, 2015-01-22) Kabue, Priscillah Njeri
    Maternal mortality rate due to pregnancy-related complications remains high at 488 per 100,000 live births in Kenya. If mothers are treated appropriately and in a timely manner, in a hospital almost all women who develop pregnancy-related complications can be saved from death and disability. The purpose of study was to assess why hospital deliveries in Kenya have remained low despite government strategies on improving health system and human resources. The objective of the study was to assess the determinants of utilization of hospital delivery and the rating of the health care services among postnatal mothers in Thika and Kangundo District Hospitals which are in Kiambu and Machakos Counties respectively. In view of this a cross- sectional study was conducted with an aim of establishing the factors that determine utilization of hospital during delivery. The study population was composed of eight hundred post natal mothers from Thika and Kangundo Districts attending Maternal Child Health Clinics who had delivered less than one year ago. Structured questionnaires and interviews were used to collect the data. In addition, Focus Group Discussions were conducted in each District and Key informants interviewed. Quantitative data was analyzed using SPSS for windows version 16 and data presented in form of tables and bar charts. The qualitative data from the focus group and Key informants was transcribed and a summary written. From the study Client oriented factors that were found to be associated with hospital delivery in both Kangundo and Thika included occupation (p = 0.028, p = 0.007), having money to go to the hospital (p = 0.000, p = 0.00), short distance from the health facility (p = 0.001, p = 0.029), and client having delivered in the hospital before (p = 0.000, p = 0.000) respectively among others. On binary regression Client oriented factors that predicted place of delivery in Kangundo were education level, previous delivery in a hospital and number of antenatal clinic attendance while in Thika they included client view of health worker, previous delivery in a hospital and economic factors. Health facility oriented factors that were associated with hospital delivery in Kangundo were lack of privacy (p = 0.000) while in Thika the manner in which the mother was handled by the health care worker (p = 0.001) and whether the mother received expected care (p =0.017). Rating of the health care services in terms of acceptability was average with only half of respondents feeling that the services were acceptable in both hospitals. In terms of accessibility 74% could access the hospital through matatus. In terms of availability time taken to be attended was rated above average while availability of health facilities and services required was below average in both districts. Quality of care during delivery was rated high in both districts with 72% of the respondents being assisted during head delivery but in terms of infection control this was above average. The research concludes that mothers do not utilize the health facility for delivery in both areas because of cost of the services, distance from the hospital, negative attitude of the health workers, lack of privacy and poor quality of care. Information generated by this study will be recommended to the policy makers in the Ministries of Health for use in addressing the challenges facing hospital delivery therefore promoting it leading to reduction in maternal morbidity and mortality.
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    Maternal awareness of reproductive health practices and its impact on adolescent pregnancy: a study of mothers in Dagoretti Community, Nairobi.
    (2014) Kabue, Priscillah Njeri; Nzyoka, Mbithi; Some, Eliab Seroney
    Unchecked high rate of pregnancy among adolescents is a major concern in the developing countries due to associated risks that include obstructed labour, abortion and high maternal morbidity and mortality. Through appropriate knowledge of reproductive health, adolescents develop correct perception that enable them to make responsible and informed choices regarding sex. Adolescents in the developing world have little knowledge of reproductive health yet there is considerable resistance to teaching reproductive health in school due to prevailing parental and religious opposition. Parents need to counsel adolescents on reproductive health in order to reduce adolescent pregnancy. Studies in the field of adolescent fertility have tended to focus on adolescents, not parents, yet parents play an important role in the upbringing of their children. Therefore, there is need to review approach of counselling adolescents. In view of this a cross-sectional study was conducted on mothers in Dagoretti, a peri-urban area of Nairobi City, with the aim of establishing maternal awareness of reproductive health practices, maternal counselling of adolescent on reproductive health issues and the extent of maternal influence on the prevention of adolescent pregnancy. Further, the study sought to find whether mothers had adequate knowledge, right attitudes and communication skills to guide and counsel adolescent girls. The study population was composed of women above 20 years with at least one child. Both structured interviews and Focus Group discussions were used to collect data. A total of 478 women responded to the structured questionnaire and 3 Focus Group discussions were held. - . Based on knowledge of family planning, fertility and sexually transmitted infections, 70% of the respondents were considered knowledgeable on reproductive health practices. Knowledge on reproductive health was positively associated with age of the respondents ci = 21.9, p = 0.038) and level of education (X2 =33.8 p = 0.0001). xii Forty-four point four percent of the respondents reported being a guardian or a mother of pregnant adolescent. Adolescent pregnancy in a home was negatively associated with respondents' educational level (X2 =11.4 P = .0.009) and religion (X2 =18.9 P = 0.018) but positively associated with number of children (X2 =13.9 p = 0.007). Majority of the mothers 59.9% (286) counselled adolescent girls who were not related to them while only 30.8% of the 240 respondents who had adolescent daughters counselled them. Counselling own adolescent daughter was positively associated with respondents' age (l =77.9 p = 0.001) also educational level (X2 =21.1 P = 0.0001) but negatively associated with number of children (X2 = 64.3 P = 0.0001). Respondents' counselling of adolescents not related to them was negatively associated with number of children (X2 = 15.3 P = 0.004) and positively associated with occupation (X2 =1L6 P = 0.021). However, maternal knowledge of reproductive health practices was not significant associated with counselling of adolescents (X: = 0.04 P = 0.8) or presence of adolescent pregnancy (X2 = 3.0 p = 0.08). The study also shows that 99.2% of the respondents do not object to teaching of reproductive health practices in schools, though 68.5% of the mothers disapprove adolescent access to family planning services claiming that this would encourage immorality and cause infertility among adolescents. The study concludes that knowledge of reproductive health practices increases with the level of education of the mother and number of children. Knowledge of reproductive health of the mother has no influence on adolescent pregnancy and adolescent child counselling. This suggests that other factors such as education and counselling skills were required among the respondents to offer guidance and counselling. This information is useful for polic makers in developing educational strategies which will empower mothers with education and counselling skills to enable them counsel adolescent girls effectively thus reducing adolescent pregnancy.