Women’s persistent utilisation of unskilled birth attendants in Kakamega County, Kenya

Abstract

Background: Minority of births in sub-Saharan Africa are conducted by skilled birth attendants. Having the highest world maternal mortality ratios and most deaths being associated with lack of trained supervision at delivery. Changing delivery practices is a major priority in this region. Objective: To determine the factors that contribute to persistent utilisation of unskilled birth attendance by women in Kakamega County. Design: A descriptive cross-sectional study . Setting: Kakamega County, Kenya Subjects: Post-natal mothers with children aged less than six months who delivered without skilled attendance. Results: Antenatal attendance rate of 92.7% while proportion of skilled birth attendance was at 48.6%. The following factors were found to influence utilisation of UBAs in the Study area: age (X2=8.65, df=3, P= 0.013), occupation (X2=10.04, df=3, P=0.006), religion (X2=19.73, df=5, P=0.0001), monthly income (X2=7.59, df=2, P=0.002), marital status (X2=10.10424, df=2, P=0.005) and education level (X2=9.472, df=4, P=0.002). Negative attitude of healthcare providers, socio-cultural practices and insecurity also enhanced utilisation of unskilled birth attendance. Conclusion: Birth preparedness should be advocated for every pregnant woman and health facilities to address the discrepancy between antenatal attendance and delivery by skilled birth attendance. We hope that the information generated from this study will be used by the policy makers leading to appropriate interventions or strategies which will reduce the number of home deliveries and maternal deaths.