Determinants of Place of Delivery among Women of Child Bearing Age Seeking Child Welfare Services in Kandara Sub County, Murang’a County

Abstract

Introduction Worldwide, half a million women die each year from pregnancy and childbirth related complications. Over 90% of these deaths occur in developing countries, including Sub-Saharan Africa (Oguntunde et al., 2010). KDHS 2010, indicates Maternal Mortality Rate (MMR) of 488/100,000 has been reported. Skilled assistance during childbirth is central to reducing maternal mortality despite it remaining below 50% since the early 1990s, (KDHS 2008/2009) Study by KNBS indicates that 43 percent of births in Kenya take place in health facilities, while 56 percent of births take place at home. Methods Data was collected using interviewer-led questionnaire on 323 women .Predictors of the woman’s most recent place of delivery were explored in an exploratory risk factor analysis using multiple logistic regressions. Data was collected from 1st April to April 22nd 2015. Results Women who had attained more education level (48.9%) preferred delivering in hospitals than at home. Majority (80%) of women were married and all of them opted for health facility delivered this could be attributed to an assured support from their husbands. A good proportion (39.3%) of the women relied on their husband for financial support. Many women 56.7% claimed that lack of information on service delivery, lack of information about services offered in hospitals encouraged many women to deliver at home. It was clear from the study findings that lack of satisfaction with service delivery discouraged most women to deliver at the hospitals. On the other hand, the findings revealed that lack of respect of cultural beliefs by the health workers encouraged women delivery at home to a moderate extent. Walking long distances to hospitals encouraged most of the women to deliver at home to a great extent. High travelling costs is a barrier to use of maternity services offered in hospitals also discouraged most77% women to deliver in hospitals. Poor infrastructure , roads encouraged most 45.2% women to deliver at home. Discussion and Conclusion The study findings indicate that there is a significant positive effect on choice of place of birth and the determinants under study namely: Socio-demographic characteristics, knowledge on safe delivery, accessibility to delivery services and attitude towards health facilities.