Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya

Abstract

The single most critical intervention in the reduction of maternal mortality is to ensure that a health worker with appropriate skills is present during pregnancy, delivery and time after delivery. The main objective of the study was to determine predictors of the utilization of skilled birth attendants among women of reproductive age in Mandera East Sub County, Kenya. The cross-sectional descriptive study consisted of use of both the qualitative and quantitative approaches for data collection. Quantitative data were collected using interviewer administered questionnaire, among 365 randomly selected consenting women who delivered a baby a year prior to the conduct of the research. Qualitative data were collected through in-depth interviews of nine women including three who utilized skilled birth attendants and six who did not. Quantitative data were analyzed using SPSS software while qualitative data from in depth interview were analyzed thematically and corroborated with results from questionnaire. Data were analyzed using Chi-square test and logistical regression to identify independent predictors of utilization of skilled birth attendants. A p-value of <0.05 was considered significant. The ages of the respondents ranged from 15-49 years with a mean of 27 ±1.391 years. The results showed antenatal attendance of 84.4% while the proportion of birth attended by Skilled Birth Attendant was low (37.8%) among women of reproductive age in Mandera East. The main predictors of utilization of skilled birth attendants were: education level of the mother, type of occupation of the mother, household income, transport to the facility, parity, reliability of transport at odd hours, occupation of husbands and decision making. Barriers to utilization of SBAs included: Availability and convenience of TBAs, poor staff attitude, limited number of SBAs, poor and unreliable transport especially at night, poor referral system, cultural beliefs and misconceptions. Despite the attendance of ANC clinics being high, the level of utilization of skilled birth attendants among the study population was still low with high number of deliveries still conducted by unskilled persons at home. This study recommends that the county government should come up with strategies of ensuring that women have access to education such as Adult Education Programme; economic empowerment of women through Business enterprises; provide attraction and retention package for healthcare staffs especially SB…