Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya

Hassan Ali Ibrahim; Ademola Johnson Ajuwon; Adesina Oladokun

doi:doi:10.11648/j.sjph.20170503.21

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Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya

Hassan Ali Ibrahim, Ademola Johnson Ajuwon, Adesina Oladokun

Published in Science Journal of Public Health (Volume 5, Issue 3)

Received: 27 February 2017 Accepted: 11 March 2017 Published: 31 March 2017

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Abstract

The single most critical intervention in the reduction of maternal mortality is to ensure that a health worker with appropriate skills is present during pregnancy, delivery and time after delivery. The main objective of the study was to determine predictors of the utilization of skilled birth attendants among women of reproductive age in Mandera East Sub County, Kenya. The cross-sectional descriptive study consisted of use of both the qualitative and quantitative approaches for data collection. Quantitative data were collected using interviewer administered questionnaire, among 365 randomly selected consenting women who delivered a baby a year prior to the conduct of the research. Qualitative data were collected through in-depth interviews of nine women including three who utilized skilled birth attendants and six who did not. Quantitative data were analyzed using SPSS software while qualitative data from in depth interview were analyzed thematically and corroborated with results from questionnaire. Data were analyzed using Chi-square test and logistical regression to identify independent predictors of utilization of skilled birth attendants. A p-value of <0.05 was considered significant. The ages of the respondents ranged from 15-49 years with a mean of 27 ±1.391 years. The results showed antenatal attendance of 84.4% while the proportion of birth attended by Skilled Birth Attendant was low (37.8%) among women of reproductive age in Mandera East. The main predictors of utilization of skilled birth attendants were: education level of the mother, type of occupation of the mother, household income, transport to the facility, parity, reliability of transport at odd hours, occupation of husbands and decision making. Barriers to utilization of SBAs included: Availability and convenience of TBAs, poor staff attitude, limited number of SBAs, poor and unreliable transport especially at night, poor referral system, cultural beliefs and misconceptions. Despite the attendance of ANC clinics being high, the level of utilization of skilled birth attendants among the study population was still low with high number of deliveries still conducted by unskilled persons at home. This study recommends that the county government should come up with strategies of ensuring that women have access to education such as Adult Education Programme; economic empowerment of women through Business enterprises; provide attraction and retention package for healthcare staffs especially SBAs; Provision of incentives to TBAs for referral of pregnant women to the facility; Strengthen referral system especially in hard to reach areas.

Published in	Science Journal of Public Health (Volume 5, Issue 3)
DOI	10.11648/j.sjph.20170503.21
Page(s)	230-239
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Skilled Birth Attendants, Antenatal Care, Traditional Birth Attendants, Maternal Mortality

References

[1]	WHO. (2013). Maternal mortality, Millennium Development Goal (MDG) 5. Retrieved July 11, 2015.
[2]	UNICEF global databases. (2013). Delivery care-institutional deliveries. Retrieved July 01, 2015.
[3]	WHO, UNICEF, The World Bank and the UNFPA. (2013). Global health observatory data: Maternal and Reproductive health.
[4]	Oshonwoh, F. E., Nwakwuo, G. C., & Ekiyor, C. P. (2014). Traditional birth attendants and women’s health practices: A case study of Patani in Southern Nigeria. Journal of Public Health and Epidemiology, 6 (8).
[5]	Fekadu, M., & Regassa, N. (2014). Skilled delivery care service utilization in Ethiopia: Analysis of rural-urban differentials based on national demographic and health survey (DHS) data. Africa Health Science, 14 (4).
[6]	Kenya Demographic and Health Survey. (2009). Final Report. Retrieved September 15, 2015.
[7]	National Council for Population and Development (NCPD). (2013). Kenya Population Situation Analysis report. Retrieved July 18, 2015.
[8]	The Kenya Demographic and Health Survey. (2014). Key Indicators. Retrieved August 11, 2015.
[9]	Kenya National Bureau of Statistics (KNBS) (2009). Kenya Demographic and Health Survey 2008-09 report. Calverton, MD: KNBS and ICF Macro.
[10]	Okoth, A. (2014). Utilization of Skilled Birth attendants among Women of Reproductive age in Central Division, Kajiado County, Kenya. Thesis, Kenyatta University.
[11]	Babalola S., & Fatusi, A. (2009). Determinants of use of maternal health services in Nigeria - looking beyond individual and household factor.
[12]	Garg, R., Shyamsander, D., Singh, T., & Singh, P. A. (2010). Study on Delivery Care Practices among women in Rural Punjab. Health and Population perspectives and Issues 33 (1), 23-33.
[13]	Moore, M., Alex, B., & George, I. (2011). Utilization of Health Care Services by pregnant mothers during Delivery. A. community based study in Nigeria. Journal of Medicine and Medical Sciences, 2 (5), 864-867.
[14]	Pathak, P. K., Singh, A., Subramaman, S. V. (2010). Economic Inequalities in Maternal health care: prenatal and Skilled Birth Attendance in India, 1992-2006. PLoS ONE 5 (10): e13593. doi: 10. 1371/journal. pone. 0013593.
[15]	Lunan, B., Clements, Z., Mahony, S., & Hope-Jones, D. (2010). Maternal Health in Malawi: Challenges and Success. Scotland Malawi partneship.

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APA Style

Hassan Ali Ibrahim, Ademola Johnson Ajuwon, Adesina Oladokun. (2017). Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya. Science Journal of Public Health, 5(3), 230-239. https://doi.org/10.11648/j.sjph.20170503.21

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ACS Style

Hassan Ali Ibrahim; Ademola Johnson Ajuwon; Adesina Oladokun. Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya. Sci. J. Public Health 2017, 5(3), 230-239. doi: 10.11648/j.sjph.20170503.21

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AMA Style

Hassan Ali Ibrahim, Ademola Johnson Ajuwon, Adesina Oladokun. Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya. Sci J Public Health. 2017;5(3):230-239. doi: 10.11648/j.sjph.20170503.21

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@article{10.11648/j.sjph.20170503.21,
  author = {Hassan Ali Ibrahim and Ademola Johnson Ajuwon and Adesina Oladokun},
  title = {Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya},
  journal = {Science Journal of Public Health},
  volume = {5},
  number = {3},
  pages = {230-239},
  doi = {10.11648/j.sjph.20170503.21},
  url = {https://doi.org/10.11648/j.sjph.20170503.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20170503.21},
  abstract = {The single most critical intervention in the reduction of maternal mortality is to ensure that a health worker with appropriate skills is present during pregnancy, delivery and time after delivery. The main objective of the study was to determine predictors of the utilization of skilled birth attendants among women of reproductive age in Mandera East Sub County, Kenya. The cross-sectional descriptive study consisted of use of both the qualitative and quantitative approaches for data collection. Quantitative data were collected using interviewer administered questionnaire, among 365 randomly selected consenting women who delivered a baby a year prior to the conduct of the research. Qualitative data were collected through in-depth interviews of nine women including three who utilized skilled birth attendants and six who did not. Quantitative data were analyzed using SPSS software while qualitative data from in depth interview were analyzed thematically and corroborated with results from questionnaire. Data were analyzed using Chi-square test and logistical regression to identify independent predictors of utilization of skilled birth attendants. A p-value of <0.05 was considered significant. The ages of the respondents ranged from 15-49 years with a mean of 27 ±1.391 years. The results showed antenatal attendance of 84.4% while the proportion of birth attended by Skilled Birth Attendant was low (37.8%) among women of reproductive age in Mandera East. The main predictors of utilization of skilled birth attendants were: education level of the mother, type of occupation of the mother, household income, transport to the facility, parity, reliability of transport at odd hours, occupation of husbands and decision making. Barriers to utilization of SBAs included: Availability and convenience of TBAs, poor staff attitude, limited number of SBAs, poor and unreliable transport especially at night, poor referral system, cultural beliefs and misconceptions. Despite the attendance of ANC clinics being high, the level of utilization of skilled birth attendants among the study population was still low with high number of deliveries still conducted by unskilled persons at home. This study recommends that the county government should come up with strategies of ensuring that women have access to education such as Adult Education Programme; economic empowerment of women through Business enterprises; provide attraction and retention package for healthcare staffs especially SBAs; Provision of incentives to TBAs for referral of pregnant women to the facility; Strengthen referral system especially in hard to reach areas.},
 year = {2017}
}

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TY  - JOUR
T1  - Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya
AU  - Hassan Ali Ibrahim
AU  - Ademola Johnson Ajuwon
AU  - Adesina Oladokun
Y1  - 2017/03/31
PY  - 2017
N1  - https://doi.org/10.11648/j.sjph.20170503.21
DO  - 10.11648/j.sjph.20170503.21
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 230
EP  - 239
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20170503.21
AB  - The single most critical intervention in the reduction of maternal mortality is to ensure that a health worker with appropriate skills is present during pregnancy, delivery and time after delivery. The main objective of the study was to determine predictors of the utilization of skilled birth attendants among women of reproductive age in Mandera East Sub County, Kenya. The cross-sectional descriptive study consisted of use of both the qualitative and quantitative approaches for data collection. Quantitative data were collected using interviewer administered questionnaire, among 365 randomly selected consenting women who delivered a baby a year prior to the conduct of the research. Qualitative data were collected through in-depth interviews of nine women including three who utilized skilled birth attendants and six who did not. Quantitative data were analyzed using SPSS software while qualitative data from in depth interview were analyzed thematically and corroborated with results from questionnaire. Data were analyzed using Chi-square test and logistical regression to identify independent predictors of utilization of skilled birth attendants. A p-value of <0.05 was considered significant. The ages of the respondents ranged from 15-49 years with a mean of 27 ±1.391 years. The results showed antenatal attendance of 84.4% while the proportion of birth attended by Skilled Birth Attendant was low (37.8%) among women of reproductive age in Mandera East. The main predictors of utilization of skilled birth attendants were: education level of the mother, type of occupation of the mother, household income, transport to the facility, parity, reliability of transport at odd hours, occupation of husbands and decision making. Barriers to utilization of SBAs included: Availability and convenience of TBAs, poor staff attitude, limited number of SBAs, poor and unreliable transport especially at night, poor referral system, cultural beliefs and misconceptions. Despite the attendance of ANC clinics being high, the level of utilization of skilled birth attendants among the study population was still low with high number of deliveries still conducted by unskilled persons at home. This study recommends that the county government should come up with strategies of ensuring that women have access to education such as Adult Education Programme; economic empowerment of women through Business enterprises; provide attraction and retention package for healthcare staffs especially SBAs; Provision of incentives to TBAs for referral of pregnant women to the facility; Strengthen referral system especially in hard to reach areas.
VL  - 5
IS  - 3
ER  -

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Author Information

Hassan Ali Ibrahim

Department of Reproductive Health, Pan African University, University of Ibadan, Ibadan, Nigeria
Ademola Johnson Ajuwon

Department of Health Promotion and Education, University College Hospital (UCH), University of Ibadan, Ibadan, Nigeria
Adesina Oladokun

Department of Obstetrics and Gynecology, University College Hospital (UCH), University of Ibadan, Ibadan, Nigeria

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APA Style

Hassan Ali Ibrahim, Ademola Johnson Ajuwon, Adesina Oladokun. (2017). Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya. Science Journal of Public Health, 5(3), 230-239. https://doi.org/10.11648/j.sjph.20170503.21

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ACS Style

Hassan Ali Ibrahim; Ademola Johnson Ajuwon; Adesina Oladokun. Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya. Sci. J. Public Health 2017, 5(3), 230-239. doi: 10.11648/j.sjph.20170503.21

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AMA Style

Hassan Ali Ibrahim, Ademola Johnson Ajuwon, Adesina Oladokun. Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya. Sci J Public Health. 2017;5(3):230-239. doi: 10.11648/j.sjph.20170503.21

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@article{10.11648/j.sjph.20170503.21,
  author = {Hassan Ali Ibrahim and Ademola Johnson Ajuwon and Adesina Oladokun},
  title = {Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya},
  journal = {Science Journal of Public Health},
  volume = {5},
  number = {3},
  pages = {230-239},
  doi = {10.11648/j.sjph.20170503.21},
  url = {https://doi.org/10.11648/j.sjph.20170503.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20170503.21},
  abstract = {The single most critical intervention in the reduction of maternal mortality is to ensure that a health worker with appropriate skills is present during pregnancy, delivery and time after delivery. The main objective of the study was to determine predictors of the utilization of skilled birth attendants among women of reproductive age in Mandera East Sub County, Kenya. The cross-sectional descriptive study consisted of use of both the qualitative and quantitative approaches for data collection. Quantitative data were collected using interviewer administered questionnaire, among 365 randomly selected consenting women who delivered a baby a year prior to the conduct of the research. Qualitative data were collected through in-depth interviews of nine women including three who utilized skilled birth attendants and six who did not. Quantitative data were analyzed using SPSS software while qualitative data from in depth interview were analyzed thematically and corroborated with results from questionnaire. Data were analyzed using Chi-square test and logistical regression to identify independent predictors of utilization of skilled birth attendants. A p-value of <0.05 was considered significant. The ages of the respondents ranged from 15-49 years with a mean of 27 ±1.391 years. The results showed antenatal attendance of 84.4% while the proportion of birth attended by Skilled Birth Attendant was low (37.8%) among women of reproductive age in Mandera East. The main predictors of utilization of skilled birth attendants were: education level of the mother, type of occupation of the mother, household income, transport to the facility, parity, reliability of transport at odd hours, occupation of husbands and decision making. Barriers to utilization of SBAs included: Availability and convenience of TBAs, poor staff attitude, limited number of SBAs, poor and unreliable transport especially at night, poor referral system, cultural beliefs and misconceptions. Despite the attendance of ANC clinics being high, the level of utilization of skilled birth attendants among the study population was still low with high number of deliveries still conducted by unskilled persons at home. This study recommends that the county government should come up with strategies of ensuring that women have access to education such as Adult Education Programme; economic empowerment of women through Business enterprises; provide attraction and retention package for healthcare staffs especially SBAs; Provision of incentives to TBAs for referral of pregnant women to the facility; Strengthen referral system especially in hard to reach areas.},
 year = {2017}
}

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TY  - JOUR
T1  - Predictors of Utilization of Skilled Birth Attendants Among Women of Reproductive Age in Mandera East Sub County, Mandera County, Kenya
AU  - Hassan Ali Ibrahim
AU  - Ademola Johnson Ajuwon
AU  - Adesina Oladokun
Y1  - 2017/03/31
PY  - 2017
N1  - https://doi.org/10.11648/j.sjph.20170503.21
DO  - 10.11648/j.sjph.20170503.21
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 230
EP  - 239
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20170503.21
AB  - The single most critical intervention in the reduction of maternal mortality is to ensure that a health worker with appropriate skills is present during pregnancy, delivery and time after delivery. The main objective of the study was to determine predictors of the utilization of skilled birth attendants among women of reproductive age in Mandera East Sub County, Kenya. The cross-sectional descriptive study consisted of use of both the qualitative and quantitative approaches for data collection. Quantitative data were collected using interviewer administered questionnaire, among 365 randomly selected consenting women who delivered a baby a year prior to the conduct of the research. Qualitative data were collected through in-depth interviews of nine women including three who utilized skilled birth attendants and six who did not. Quantitative data were analyzed using SPSS software while qualitative data from in depth interview were analyzed thematically and corroborated with results from questionnaire. Data were analyzed using Chi-square test and logistical regression to identify independent predictors of utilization of skilled birth attendants. A p-value of <0.05 was considered significant. The ages of the respondents ranged from 15-49 years with a mean of 27 ±1.391 years. The results showed antenatal attendance of 84.4% while the proportion of birth attended by Skilled Birth Attendant was low (37.8%) among women of reproductive age in Mandera East. The main predictors of utilization of skilled birth attendants were: education level of the mother, type of occupation of the mother, household income, transport to the facility, parity, reliability of transport at odd hours, occupation of husbands and decision making. Barriers to utilization of SBAs included: Availability and convenience of TBAs, poor staff attitude, limited number of SBAs, poor and unreliable transport especially at night, poor referral system, cultural beliefs and misconceptions. Despite the attendance of ANC clinics being high, the level of utilization of skilled birth attendants among the study population was still low with high number of deliveries still conducted by unskilled persons at home. This study recommends that the county government should come up with strategies of ensuring that women have access to education such as Adult Education Programme; economic empowerment of women through Business enterprises; provide attraction and retention package for healthcare staffs especially SBAs; Provision of incentives to TBAs for referral of pregnant women to the facility; Strengthen referral system especially in hard to reach areas.
VL  - 5
IS  - 3
ER  -

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