Factors influencing place of delivery for pastoralist women in Kenya: a qualitative study

BMC Women's Health

Research Article

John Nduba¹  Pamela Onyo¹  Josephat Nyagero¹  Alison Morgan²  Michelle Kermode²  Tanya Caulfield²  Abbey Byrne² 

[1] Amref Health Africa, Amref Health Africa Headquarters, Langata Road, Wilson Airport, Nairobi, Kenya;The Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Level 4, Alan Gilbert Building, 161 Barry St, 3010, Carlton, Victoria, Australia;

关键词: Pastoralist;    Traditional birth attendants;    Homebirths;    Skilled birth attendants;    Kenya;    Culture;   

DOI  :  10.1186/s12905-016-0333-3

 received in 2015-06-27, accepted in 2016-08-02,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundKenya’s high maternal mortality ratio can be partly explained by the low proportion of women delivering in health facilities attended by skilled birth attendants (SBAs). Many women continue to give birth at home attended by family members or traditional birth attendants (TBAs). This is particularly true for pastoralist women in Laikipia and Samburu counties, Kenya. This paper investigates the socio-demographic factors and cultural beliefs and practices that influence place of delivery for these pastoralist women.MethodsQualitative data were collected in five group ranches in Laikipia County and three group ranches in Samburu County. Fifteen in-depth interviews were conducted: seven with SBAs and eight with key informants. Nineteen focus group discussions (FGDs) were conducted: four with TBAs; three with community health workers (CHWs); ten with women who had delivered in the past two years; and two with husbands of women who had delivered in the past two years. Topics discussed included reasons for homebirths, access and referrals to health facilities, and strengths and challenges of TBAs and SBAs. The data were translated, transcribed and inductively and deductively thematically analysed both manually and using NVivo.ResultsSocio-demographic characteristics and cultural practices and beliefs influence pastoralist women’s place of delivery in Laikipia and Samburu counties, Kenya. Pastoralist women continue to deliver at home due to a range of factors including: distance, poor roads, and the difficulty of obtaining and paying for transport; the perception that the treatment and care offered at health facilities is disrespectful and unfriendly; lack of education and awareness regarding the risks of delivering at home; and local cultural values related to women and birthing.ConclusionsUnderstanding factors influencing the location of delivery helps to explain why many pastoralist women continue to deliver at home despite health services becoming more accessible. This information can be used to inform policy and program development aimed at increasing the proportion of facility-based deliveries in challenging settings.

【 授权许可】

CC BY   
© Caulfield et al. 2016