Psychological Factors that Promote Maternal Home Delivery in Kibera Informal Settlement in Nairobi County, Kenya
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Date
2015-02-16
Authors
Ekessa, Joan Khainja
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Home births continue to be witnessed in the informal settlements in spite of the risks
involved, but it is not clear why they persist. The objectives of the study were to:
establish whether there is any effect of social and cultural practices on home delivery
in Kibera informal settlement; establish psychological factors that promote home
delivery among mothers in Kibera informal settlement; establish whether there is any
effect of a pregnant woman's (or mother's) level of education on home delivery; and
establish the strategies that can be put in place to improve hospital delivery in order to
discourage home delivery The study was guided by the Health Belief Model and the
Behavioural Model of Health Services Utilisation. A mixed survey method design
was used for the study. The study targeted all women of between 18 and 49 years of
age who had previously given birth at home in the Kibera informal settlements in
Nairobi County. Using Snowballing sampling technique 45 women who had given
birth at home were identified and participated in the actual study. Data was collected
by use of questionnaires and interview schedules where all 45 women were given
questionnaires to fill while five out of these were interviewed. Prior to the actual data
collection, a pilot study was carried out in Kibera informal settlement among five
women who had previously given birth at home. The pilot study helped to improve
the reliability and validity of the instruments by ironing out any ambiguities found in
the data collection tools. Data collected was both qualitative and quantitative.
Quantitative data collected was analysed using both descriptive and inferential
statistics, coded and entered into Statistical Package for Social Sciences (SPSS)
programme for analysis. Data analysis was presented in form of frequency
distribution tables, bar graphs and pie charts. A Chi -square test was conducted to find
out the relationship between mothers' level of education and influence on home
delivery. Qualitative data was put under themes consistent with the research
objectives. The study established that social and cultural practices, psychological
factors and level of education had a significant influence towards maternal home
delivery. In particular women's beliefs, attitude and perceptions had a great impact
towards their decision making on maternal home delivery or maternal hospital
delivery. It was established from the findings that culture, lack of education, poverty
and accessibility to hospitals were major reasons that influenced women's decision on
where to give birth to their babies. Preference for home delivery was associated with
social support emanating from strong cultural background that honoured and
celebrated motherhood. However, the major reason which inclined women to prefer
hospital delivery was associated with good medical advice and service in case of
complications during birth. Based on the findings, the study recommends that health
facilities should improve their support services for mothers delivering in their
facilities to attract more support and participation from community members who
would like to work together with health authorities to jointly design suitable health
systems that can respond to the maternal health needs hence eradicating negative
social and cultural practices in the society. In addition the government needs to work
towards increasing accessibility to hospitals by formulating programs to cater for
maternity fees to ensure that all women get access to health facilities. The major
reason which influenced most of the women to prefer maternal home delivery was
low level of education, therefore, this study recommends that education and in
particular women's education should be promoted. Chi-square test results revealed
that women with higher level of education were less likely to engage in social and
cultural practices and therefore, were psychologically inclined to deliver in hospital.
On the other hand, results of the analysis showed that women with low level of
education were more likely to engage in social and cultural practices and hence,
psychologically inclined to deliver at home. Further, the government should promote
campaigns to sensitize women on importance of maternal hospital delivery and hence
highlight dangers related to maternal home delivery
Description
Department of Psychology, 100pg. June 2013