Opportunities and challenges in implementing community based skilled birth attendance strategy in Kenya

BMC Pregnancy and Childbirth

Adetoro A Adegoke³  Shiphrah Kuria¹  Charlotte Warren⁴  Margaret Titty Mannah² 

[1] Reproductive Health Division, Ministry of Public Health and Sanitation, Nairobi, Kenya;Ministry of Health and Sanitation, Freetown, Sierra Leone, West Africa;Liverpool School of Tropical Medicine, Pembroke Pl Liverpool, Merseyside L3 5QA, UK;Population Council, Ralph Bunche Road, Nairobi, Kenya

关键词: MDG5;    Safe motherhood;    Maternal health;    Kenya;    Community midwifery;    Skilled birth attendants;    Community based skilled birth attendance;   

Others  :  1125631
DOI  :  10.1186/1471-2393-14-279

 received in 2013-12-04, accepted in 2014-08-13,  发布年份 2014

【 摘 要 】

Background

Availability of skilled care at birth remains a major problem in most developing countries. In an effort to increase access to skilled birth attendance, the Kenyan government implemented the community midwifery programme in 2005. The aim of this programme was to increase women’s access to skilled care during pregnancy, childbirth and post-partum within their communities.

Methods

Qualitative research involving in-depth interviews with 20 community midwives and six key informants. The key informants were funder, managers, coordinators and supervisors of the programme. Interviews were conducted between June to July, 2011 in two districts in Western and Central provinces of Kenya.

Results

Findings showed major challenges and opportunities in implementing the community midwifery programme. Challenges of the programme were: socio-economic issues, unavailability of logistics, problems of transportation for referrals and insecurity. Participants also identified the advantages of having midwives in the community which were provision of individualised care; living in the same community with clients which made community midwives easily accessible; and flexible payment options.

Conclusions

Although the community midwifery model is a culturally acceptable method to increase skilled birth attendance in Kenya, the use of skilled birth attendance however remains disproportionately lower among poor mothers. Despite several governmental efforts to increase access and coverage of delivery services to the poor, it is clear that the poor may still not access skilled care even with skilled birth attendants residing in the community due to several socio-economic barriers.

【 授权许可】

   
2014 Mannah et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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