Browsing by Author "Maingi, Nancy"

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    Determinants of utilization of health facility during child birth by women aged 15-49 years in Matinyani sub-county in Kitui County, Kenya
    (2014-08-27) Maingi, Nancy
    A demographic health survey done in Kenya in the year 2009 revealed that 54% of births in Eastern Province are conducted at home by TBAs and relatives and obstetric care services are unavailable in most of the rural health facilities. A report by Kitui District Development Plan 2008-2012 indicates that despite 20% of women delivering in a health facility, over 80% deliver at home with 70% of the deliveries being assisted by TBAs. Across the County, the majority of maternal death and disabilities occur from preventable causes that can be averted through skilled attendance at birth, backed up with emergency care. This precisely indicate that the uptake of the health services of skilled attendance at birth is low; this also posed a lot of questions as to why 93% of women in Eastern province would seek ANC services yet 70% deliver in the hands of unskilled attendants. This study was aimed at identifying the determinants of utilization of health facility during childbirth by women aged 15-49 years in Matinyani Sub county, in Kitui county. It was a facility- based study conducted in Matinyani Sub county where 376 women and 6 health facilities were included. It was a descriptive cross-sectional study. The variables tested were utilization of health facility during child birth, client related factors, provider related factors and health facility related factors. Data collection was done using focused group discussions guide, interview schedule guide, observation and analysis was done using SPSS version 17. Chi test was used to show association between the variables Majority of the respondents 138 (36.7 %) were between 25-30 years, 125 (33.2 %) betweenZfl-Zfiyears, 58 (15.4 %) between 30-35 years, 31 (8.2%) between 15-20 years and 24 (6.4%) above 35 years. At least 66.2%(n=249) of the respondents highest level of education was primary school,30.3% (n=114) had secondary education and only 3.5%(n=13) had tertiary education.Fifty eight percent (n=218) of the respondents deliver at home,while 42% (n=158) deliver in health facilities. About 33.8% (n=127) of the respondents deliver under TBAs, 18% (n=68) are assisted by relatives, 6% (n=23) are unassisted. Some of the major reasons for home delivery included distance to health facility, travel cost and weak referral systems. There was a significant relationship between marital status and utilization of health facility during child birth (x2=0.040 1; df=2; p<0.05). There was a significant relationship between religion and utilization of health facility during child birth (x2=0.0401; df=l; p<0.05).At least 99% (n=373) of the respondents attended antenatal clinic during pregnancy but only 53% (n=202) managed to attend the four recommended visits. Eighty six percent (n=324) had health education on maternal-health. Only 43% (n=164) of the respondents made own decision on where and who to assist them during delivery. The proportion of women not utilizing SBA were58%, with 33.8% being assisted by traditional birth attendant. Ninety nine percent attended ANC but only 53.7% made the recommended four visits. Majority of health workers were trained on FANC but not trained on comprehensive RH. Despite availability of some essential drugs for management of obstetric complications, in majority of the facilities they were expired. From the study findings it is recommended that community to be health educated on importance of hospital delivery, dangers associated with home delivery by the government. All health workers to be educated on drug storage to avoid expiry hence wastage of drugs. The government and the community should strengthen the referral systems in the sub county.
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    Health Education Intervention on Uptake of Emergency Obstetric and Newborn Care Services among Women of Reproductive Age in Nakuru County Kenya
    (Kenyatta University, 2024-01) Maingi, Nancy
    Emergency obstetric and newborn care (EmONC) services enhances maternal survival. The study established health education intervention on uptake of Emergency Obstetrics and Newborn care services. The focus was Socio demographic, social cultural and social economic factors. The study was a randomized control trial and utilized a mixed method. Multistage sampling was used. Key informants were purposefully selected Allocation to each study group was done on a 1:1 ratio; hence each group had 191 participants. To determine the sample size, Kelsey et al., 1996 formula for randomized controlled trials was used and in order to take care of attrition 10% increase was done hence the sample size was 382 women. Pregnant mothers 26-32 weeks of gestation were enrolled. Structured questionnaire, focused group discussion and key informant interview schedules used to collect data. In phase I baseline data from documented guidelines, FGDs, KII was collected. Phase II the intervention tool was developed and verified by an obstetrician and a midwife while in Phase III was the recruitment phase. A pre-test was conducted at Kuresoi North Sub County where 10% of the questionnaires was used. To ensure validity, research assistants were trained on the various research instruments. Descriptive statistics, Fisher’s exact test at bivariate and odds ratio at multivariate analysis level were computed. Qualitative data was analysed using Nvivo data analysis software. Ethical consent for the research was sought from research ethical committee at Kenyatta University, National council for Science and Technology and Ministry of health. Before commencing the study, informed consent was obtained from respondent. The intervention group had 95.93% (n =165) utilization of EmONC services in comparison to the control arm 75.29% (n = 128). There was no difference in both groups from base line to final survey OR 1.209,CI 0.742 to 1.969 and P-value 0.446.The level of education significantly influenced utilization at χ2 40.402 and a p value <0.001. Secondary education influences utilization of EmONC services at AOR 8.791 95% CI 3.631 TO 21.285 and a P-value <0.001. Respondents with tertiary education were 2.5 times likely to utilize EmONC services. Parity was significant at χ2 43.724, p value <0.001.There was no significant difference between socioeconomic factors and utilization of EmONC services at baseline level. There was no variation between sociocultural factors and utilization of EmONC services. Mothers that received the intervention were seven times likely to utilize EmONC services at χ2 29.662 95% CI 3.363 – 17.787, & a p-value <0.001. After administration of the Health Education intervention package, the respondents were eight times likely to utilize the services at OR 8.552,95% CI 3.705 TO 19.742,P-value <0.001. From the study findings the utilization of EmONC services increased after intervention. It is recommended to educate the health workers to know the importance of health education on the uptake of services and administer it. Increasing identical health education interventional approaches to enhance utilization of EmONC services care in Kenya where there is low utilization. Further study is required on the health education approaches for improving utilization of health services and also focus on community health education on utilization EmONC services.