Utilization of Free Skilled Birth Attendance Services among Women of Reproductive Age in Public Health Facilities in Kitui County, Kenya
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According to World Health Organization 358,000 maternal deaths occur annually worldwide with 99% of this deaths occurring in developing countries. Over the years Kenya has recorded poor maternal indicators among them high maternal mortality rate which stands at 362 per 100,000 live births with neonatal mortality rate at 22 per 1,000 births and declining trends in utilization of maternal services as evidenced by low utilization of skilled birth attendants. Reduction of maternal mortality is a global priority particularly in developing countries through increasing utilization of skilled birth attendants. Therefore the purpose of this study was to determine utilization of free skilled delivery services among women of reproductive age in public health facilities in Kitui South Sub County, Kenya. Maternal and neonatal deaths are still reported in the region despite the National and County government efforts in putting strategies to avoid preventable deaths and morbidity. The objective of the study was to explore utilization of free skilled delivery services among women of reproductive age in the public health facilities in Kitui South Sub County. The research employed three delay model of health care utilization as the conceptual framework. Cross sectional population based descriptive study was used. Data was collected using pretested and structured questionnaires targeting women who had previously delivered in the preceding last one year, focused group discussions were done and in-depth interview with key informants. Pre-testing of research instruments was done to ensure validity and reliability. Systematic,simple random and purposive sampling was used to select the desired sample. Quantitative data collected was coded and analyzed using statistical package for social sciences (SPSS) Version 24, and presented using tables, pie-charts and bar graphs. Qualitative data was transcribed and thematically organized and analyzed accordingly.In conclusion the study found out that ANC attendance was at 98.1%, SBA at 65.9%, mode of delivery SVD at 74.1% and Caesarean section at 25.9% in the study area. From the findings it was confirmed that social, cultural and economic factors significantly influenced utilization of SBA in the area of the study as follows: Religion (χ 2=8.11,d.f=3, p=0.004), Employment status (χ2=69.85,d.f=1, p<0.001), Level of education (χ2=21.55,d.f=3,p<0.001). Health system factors had a strong positive relationship in influencing utilization of SBA in the area of the study as shown;Cost of transport (χ2=18.99,d.f=4,p<0.001), Facility operates 24 hours (χ2=44.19,df=2,p<0.001). Recommendation from the study to the national and county governments is to improve health facilities infrastructure, employ more staffs, increase capacity building of the staffs, create awareness to community members on utilization of maternal health services, increase supplies in hospitals, strengthening referral systems, male involvement, empowerment of women and work on staff motivation and retention.This will translate in improvement of the utilization of skilled birth attendance thus reducing the burden of maternal and neonatal mortality and morbidity in the County and whole Country.