EFFECT of the DISTANCES of PUBLIC HEALTH FACILITIES from the NEAREST MAJOR ROADS on SKILLED DELIVERIES CONDUCTED in KISUMU COUNTY, KENYA

Abstract

The project sought to describe health facility accessibility and its effect on skilled delivery in Kisumu in line with the pillars of UHC. Proportion of skilled deliveries for 156 public health facilities conducted in 2016 was mined from DHIS2. Healthcare physical services accessibility was represented using a 5km radius fixed distance buffering around health facilities and the health facilities' distances to the nearest major roads. Simple linear regression was then done between distances of the health facilities to their nearest major roads and skilled deliveries conducted in the health facilities. The mean skilled delivery was 42.5% (Median Combining double low line 45.8%, Range 0 to 358% and IQR Combining double low line 48.6%). There exist 4 pockets of underserved areas in Nyando, Nyakach and Muhoroni sub counties measuring 21 km2, 52 km2, 60 km2, 65 km2 and 94 km2 respectively. Distance from the nearest road to skilled deliveries conducted, showed the R2 value was 0.02. The study found out that underserved areas are located away from major roads. The mean skilled delivery was lower than the national of 65%. However some facilities exceeded 100%. This can be explained by in referrals that cause such facilities to exceed their projected workloads. The distance of a health facility to the nearest major road is inversely proportional to the skilled deliveries conducted meaning that the further a heath facility is from a major road, lesser the skilled deliveries conducted in that facility and vice versa. However, this model is weak in establishing such an effect because of the low R2 value. In conclusion, there are pockets of underserved areas in Kisumu and distance of health facilities from the nearest major road does not significantly affect the conduct of skilled deliveries in Kisumu County.