Birth attendance and magnitude of obstetric complications in Western Kenya: a retrospective case–control study

BMC Pregnancy and Childbirth

Shiphrah N Kuria¹  Wilson N Liambila² 

[1] The Division of Reproductive Health, Department of Family Health, Ministry of Health, Mbagathi Road (Old), P.O. Box 43319, Nairobi, Kenya;Population Council, P.O. Box 17643, Nairobi, 00500, Kenya

关键词: Kenya;    Unskilled attendants;    Skilled attendants;    Community level;    Postpartum women;    Risk factors;    Child birth related complications;    Birth attendance;   

Others  :  1125512
DOI  :  10.1186/1471-2393-14-311

 received in 2014-05-02, accepted in 2014-08-19,  发布年份 2014

【 摘 要 】

Background

Skilled birth attendance is critical in the provision of child birth related services. Yet, literature is scanty on the outcomes of child birth related complications in situations where majority of women deliver under the care of non-skilled birth attendants compared to those who are assisted by skilled providers. The study sought to assess the nature of childbirth related complications among the skilled and the non-skilled birth attendants in Western Kenya.

Methods

A case–control study was conducted among women aged 15–49 years at the household. Controls were individually matched to cases on the basis of age and socio-economic status. A total of 294 cases and 291 controls were interviewed. Data were collected on various demographic and socio-economic characteristics and women’s perception on the quality of care. All independent variables were analysed initially in bivariate models and those that were significantly associated with obstetric complications were included in multiple logistic regression model in order to control for confounding factors. Odds ratios (ORs), with 95% confidence intervals, were computed to show the association between the occurrence, magnitude and the extent to which child birth related complications were managed.

Results

Demographic and socio-economic characteristics of the cases and controls were similar. About 52% of the deliveries were assisted by skilled birth attendants while non-skilled providers attended to 48% of them. The odds of the occurrence of obstetric complications were greater among the women who were attended to by skilled providers in health facilities: adjusted odds ratio (AOR): 1.32 (CI 0.95, 1.84) than among those who were assisted by unskilled birth attendants, AOR 0.76 (CI 0.55, 1.06). Undignified care, high delivery and transport costs and fear of hospital procedures such as HIV tests and mishandling of the placenta were cited as some of the barriers to facility deliveries.

Conclusion

Skilled birth attendants in facilities were associated with higher odds of the occurrence of obstetric complications compared to deliveries that were assisted by non-skilled attendants at home. Women cited many barriers which need to be addressed in order to improve their access to skilled providers for delivery and in managing obstetric complications.

【 授权许可】

   
2014 Liambila and Kuria; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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