Predictors of utilization of skilled birth attendants among women of reproductive age in Turkana central sub-county, Turkana County, Kenya
Etee, Peter Ekaran
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Skilled Birth Attendance is one of the most important interventions in reducing maternal mortality. The proportion of births assisted by skilled attendants in Kenya is 62% while in Turkana Central Sub County is 22%. Maternal mortality in Kenya is estimated to be 495 per 100,000 live births. This worrying trend of maternal mortality is thought to be as a result of unskilled attendants at birth. This study sought to determine the factors that influence utilization of skilled birth attendants among women of reproductive age in Turkana central sub county, Turkana county. The objectives of the study were to: determine the demographic, social economic and socio cultural factors that influence utilization of skilled birth attendants among women of child bearing age; to establish health system factors influencing the utilization of skilled birth attendants among women of child bearing age in Turkana central sub county, and to determine the knowledge, attitudes and practices of women of child bearing Age on utilization of skilled birth attendants in Turkana Central sub county. The study employed a descriptive cross-sectional study utilizing quantitative and qualitative approaches targeting women of reproductive age. A total of 266 women of reproductive age were interviewed. Interviewer administered questionnaire and focused group discussion were also administered. Informed consent was obtained from the respondents and privacy and confidentiality was assured. Quantitative data was analysed using SPSS version 20.0 and presented in figures, tables, frequencies and graphs, while qualitative data was organized and analyzed thematically. The results showed antenatal attendants rates of 45.3% while proportion of deliveries attended by skilled attendant was 41.4%. The main predictors of utilization of skilled birth attendants are FP practice OR=0.488 (10.286 – 0.831), p=0.008 and attended ANC OR=3.047 (1.6 – 5.8801), p=0.001. Others were what respondent does for a living OR=11.284 (1.894 – 67.230), p=0.008, and means of transport to health facility OR = 6.84 (21.075 – 27.168), p<0.001. The study recommends that women of child bearing age should be empowered with knowledge, higher social and economic status to be able to make informed decision concerning their own health and pregnancy outcomes in order for them to access timely skilled care at delivery. Health system barriers such as transport and communication, poor referral systems, limited infrastructure and social cultural beliefs need to be addressed by all stakeholders to improve access and utilization of skilled birth attendants by deploying more skilled attendants in rural areas and hard to reach areas to scale up utilization of skilled delivery. There is also need to intensify health promotion to address negative socio cultural beliefs and taboos. The interventions will help scale up utilization of SBAs and hence improved pregnancy outcomes.