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• Presenter: Joyce Cheptum

• Session: MDGs - Progress made and lessons: MNCH

• This program has received financial support from MAISHA project.

• Potential for conflict(s) of interest: – There is no conflict of interest.

Canadian Conference on Global Health

DEDAN KIMATHI UNIVERSITY OF TECHNOLOGY

A DFATD funded maternal – infant health project

A collaboration of Dedan Kimathi University of Technology - KENYA and College of The Rockies -CANADA

Authors: Cheptum JJ, Gitonga MM, Mutua EM, Mukui SM, Ndambuki JN and Koima WJ

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Estimated 150,000 women in Africa and 7,700 in Kenya die each year from causes related to pregnancy and childbirth (ROK, 2010).

More than 3 million newborn babies die every year. (WHO, 2012)

Children in sub-Saharan Africa face the highest risk of mortality (UNICEF, 2009).

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In Kenya, many deliveries take place in the villages.

According to KDHS 2008-09, 44% deliveries occur under skilled birth attendance.

Kenya yet to achieve the MDG 4 and 5.

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Infant mortality in Nyanza is 95 per 1000 live births (KDHS 2008-09).

The immunization coverage is 51.6% lower than Kenya’s 75% (District Health Statistics, 2012).

Migori County - health facility deliveries is 32.5% and skilled birth attendance is 35.1% (KNBS, 2012).

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Maternal and newborn health are closely linked.

Access and utilization of maternal health services in the health facilities has been linked with improved maternal and neonatal health outcomes, 75% of maternal deaths can be prevented (Babalola, 2009, WHO, 2001).

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To identify barriers to access and utilization of maternal and infant health services.

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A cross sectional study design employing qualitative and quantitative methods,

Study population - women of reproductive age (15 – 49 years) and men.

Researcher - administered questionnaire, Key Informant Interview and FGD were used.

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446 women interviewed

Mean age was 25.9 years.

Most women were multiparaous 316 (65.7%)

Average number of children per woman was four.

Primary level of education - 357(80%)

Most of the respondents did not have a formal employment – 415 (93%).

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ANC non-attendance Odds Ratio P>|z| [95% Conf. Interval]

No. of Pregnancies 0.86 0.025 0.7543 0.9817

Religion 0.76 0.026 0.5906 0.9670

Education level 1.77 0.018 1.1036 2.8300

Occupation 0.06 0.005 0.7094 0.9409

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Place of delivery Odds Ratio P>|z| [95% Conf. Interval]

No. of Pregnancies 0.82 0.000 0.7589 0.9033

Marital status 1.51 0.003 1.1468 1.9835

Education level 1.67 0.029 1.0554 2.6499

Occupation 0.83 0.007 0.7185 0.9489

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PNC attendance Odds Ratio P>z [95% Conf. Interval]

Age 0 .90 0.001 0.8521 0.9580

No. of Pregnancies 1.21 0.013 1.0403 1.3969

Education level 1.48 0.113 0.9110 2.4029

Occupation 1.19 0.029 1.0180 1.3951

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“Fathers should not see where the child is coming from because the husband may not go in again” (FGD - women)

“Fathers are mainly the decision makers in where to deliver, however some give their wives to decide where to deliver” (FGD - women)

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“There is inadequate staff and equipment especially Reproductive Health equipment (delivery and infant resuscitation equipment)”. (KII)

“They (TBAs) are never rude and they give you the best services. They give you porridge and bathe you until you are ready to leave”. (FGD)

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• Barriers to access and utilization of maternal and infant health services in the rural areas could be attributed to socio-cultural factors such as decision making vested on the men.

• Inadequate staff and equipment hinders utilization and access of the services

• Financial barriers may be attributed to low level of education which may contribute to low income due to unemployment.

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Access and utilization of maternal health services is a hindered by socio-economic, socio-cultural and health facility factors.

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Addressing the several barriers hindering access and utilization of maternal and infant health services is a step towards achievement of MDGs 4 and 5.

Success to improving access and utilization of maternal and infant health services requires involvement of the community and the government in policy making.

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DFATD Canada for funding

College of the Rockies - Moritz Schmidt and team

Dedan Kimathi University of Technology

Health management team– Migori County

Community members of Migori County

www.cotr.bc.ca/MAISHA

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Thank

You

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