A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: baseline survey on maternal health

Afr Health Sci. 2019 Jun;19(2):1841-1848. doi: 10.4314/ahs.v19i2.6.

Abstract

Background: Maternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities.

Objectives: The study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya.

Methods: This was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016.

Results: A total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility.

Conclusion: Findings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester.

Keywords: Kenyan communities; System approach; maternal and child health care.

MeSH terms

  • Adult
  • Child
  • Community Health Centers / organization & administration
  • Contraception Behavior
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kenya
  • Maternal Health*
  • Maternal Mortality
  • Maternal-Child Health Centers / organization & administration*
  • Maternal-Child Health Services / standards*
  • Patient Compliance*
  • Pregnancy
  • Prenatal Care / statistics & numerical data*
  • Primary Health Care / methods*
  • Primary Health Care / organization & administration
  • Socioeconomic Factors