Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009

BMC Pregnancy and Childbirth

Gail Davey²  Sarah Lewis³  John Kitui¹ 

[1] Medical Doctor and Public Health practitioner, PO Box 4798, Eldoret, Kenya;Brighton & Sussex Medical School, Rm 2.16, Brighton, BN1 9PX, UK;Faculty of Medicine & Health Sciences, University of Nottingham, Room C116 Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK

关键词: Delivery;    Still birth;    Neonatal mortality;    Maternal mortality;    Maternal and child health;   

Others  :  1138229
DOI  :  10.1186/1471-2393-13-40

 received in 2012-05-17, accepted in 2013-02-14,  发布年份 2013

【 摘 要 】

Background

Maternal mortality in Kenya increased from 380/100000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990s. We use the 2008/2009 Kenya Demographic and Health Survey data to describe the factors that determine where women deliver in Kenya and to explore reasons given for home delivery.

Methods

Data on place of delivery, reasons for home delivery, and a range of potential explanatory factors were collected by interviewer-led questionnaire on 3977 women and augmented with distance from the nearest health facility estimated using health facility Global Positioning System (GPS) co-ordinates. Predictors of whether the woman’s most recent delivery was in a health facility were explored in an exploratory risk factor analysis using multiple logistic regression. The main reasons given by the woman for home delivery were also examined.

Results

Living in urban areas, being wealthy, more educated, using antenatal care services optimally and lower parity strongly predicted where women delivered, and so did region, ethnicity, and type of facilities used. Wealth and rural/urban residence were independently related. The effect of distance from a health facility was not significant after controlling for other variables. Women most commonly cited distance and/or lack of transport as reasons for not delivering in a health facility but over 60% gave other reasons including 20.5% who considered health facility delivery unnecessary, 18% who cited abrupt delivery as the main reason and 11% who cited high cost.

Conclusion

Physical access to health facilities through distance and/or lack of transport, and economic considerations are important barriers for women to delivering in a health facility in Kenya. Some women do not perceive a need to deliver in a health facility and may value health facility delivery less with subsequent deliveries. Access to appropriate transport for mothers in labour and improving the experiences and outcomes for mothers using health facilities at childbirth augmented by health education may increase uptake of health facility delivery in Kenya.

【 授权许可】

   
2013 Kitui et al.; licensee BioMed Central Ltd.

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