Knowledge and Perceptions towards Utilization of Obstetric Fistula Screening Services among Women of Reproductive Age in Makueni County, Kenya
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Date
2021
Authors
Mbinya, Mary Maundu
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Globally, it is estimated that more than half a million women of reproductive age die from complications related to pregnancy and childbirth with 99% of this occurring in Sub-Saharan Africa and Asia. Obstructed labor occurs in an estimated 5% of pregnancies and accounts for 8% of all maternal deaths. Approximately more than 2 million young women live with untreated obstetric fistulae Worldwide. This study therefore sought to assess the knowledge and perceptions towards utilization of obstetric fistula screening services in Makueni County Kenya. The study mainly focused on socio-demographic factors, knowledge, perceptions and utilization of obstetric fistula services among women of reproductive age in Makueni County. The study adopted a descriptive cross-sectional study design. The study was conducted in selected wards of Makueni Sub-county of Makueni County. The study used both quantitative and qualitative data collection methods. Quantitative data was collected using semi-structured questionnaires administered by trained research assistants. Qualitative data was collected using focused group discussions sessions with women of reproductive age held in each selected ward. Additional information was obtained through holding key informant interviews healthcare providers. The study targeted 422 primary respondents who were residents of Makueni County. Makueni sub-county was randomly selected while two wards of Wote and Kitise were purposively selected. Systematic random sampling was used to select primary respondents at a predetermined interval of 6. Every 6th household with a woman of reproductive age was selected for interview until the required sample size was reached. The researcher obtained ethical clearance from the Kenyatta University Ethical Review Committee prior to data collection and a research permit from National Commission for Science, Technology and Innovation. Informed consent was sought from study respondents while the purpose of the study was explained concurrently. Quantitative data was cleaned and entered into a Microsoft excel database before being analyzed by SPSS version 22.0. Descriptive statistics were presented using percentages, frequency tables, graphs and pie-charts. Inferential statistics were calculated to establish the association between study variables using chi-square tests done at 95% confidence interval and p-values of less than 0.05 considered statistically significant. Factors which were statistically significant Univariately were subjected to a multiple logistic regression with Utilization of the Fistula Services as the response factor/independent variable. Qualitative data from Focused Group Discussions (FGDs) and Key Informant Interviews (KII) were examined and triangulated with quantitative data as direct quotes or narrations from respondents. The results revealed that only 32% (95%CI, 27% - 37%) of respondents utilized obstetric fistula services in which counseling was the most sought service at 44.4% (95%CI, 36% - 53%). Majority of socio-demographic factors such as age (p=0.001), level of education (p=0.002), Occupation (p=0.001) and average monthly family income (p=0.011) significantly influenced utilization of fistula services. Sixty two percent (CI) of respondents had low knowledge on obstetric fistula. Knowledge levels were significantly associated with utilization of obstetric fistula (p=0.037). Seventy one percent (CI) of respondents had negative perceptions towards developing obstetric fistula. The study concludes that there were low utilization rates, low knowledge levels and negative perceptions towards obstetric fistula services in Makueni County. The findings of this study would help relevant stakeholders in structuring programs and strategize on interventions related to creation of community awareness and thus improve the health seeking behaviors towards utilization obstetric fistulae screening services. These results would also be of use by the Ministry of Health for purposes of health education and for policy formulation and implementation with regards to workable short-term and long-term obstetric fistulae intervention.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Reproductive Health) in the School of Public Health and Applied Human Sciences of Kenyatta University, September, 2021
Keywords
Knowledge Perceptions, Utilization, Obstetric Fistula, Screening Services, Women, Reproductive Age, Makueni County, Kenya