Maingi, Nancy2024-09-272024-09-272024-01https://ir-library.ku.ac.ke/handle/123456789/28951A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Doctor of Philosophy in Public Health (Reproductive Health) in the School of Health Sciences of Kenyatta University January, 2024 Supervisors: 1. Margaret Keraka 2. Drusilla MakworoEmergency 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.enThesis