Implementing a Community-Based Participatory Approach to Promote Health Facility Delivery among Women of Reproductive Age in Kanamai Area, Kilifi County
Abstract:
Maternal utilization has been low over
the years in Kenya. Approaches to establish safe motherhood through promotion of
health facility have been equally fronted. This study applied certain aspects of
community education approach encompassing group discussion and community dialogue
to provide a clear insight of how the approach is a vital tool. Community based
cross sectional study was conducted in Kanamai sub-location, Kilifi County to recruit
232 women selected by simple random sampling technique. The data were collected
using pre-tested semi-structured questionnaires and the collected data was coded,
entered, cleaned, and analysed using R for Windows (version 4.0.3). Sixty-nine percent
(69%) of women advocated for the delivery at the designated health facilities. Independent
factors that were found to influence health facility based delivery in this study
were being employed (OR = 12.42, 95% CI: 6.25 - 24.70, p<0.0001), having given
birth to 3-4 children, (OR = 2.56, 95% CI: 6.25 - 24.70, p=0.0062) and rating of
both group discussion (OR = 0.15, 95% CI: 0.03 -0.66, p=0.0041) and community dialogue
(OR = 0.21, 95% CI: 0.08 - 0.59, p=0.0013) to be low. Leading by the example set
by the government of offering free maternal services, engaging the key stakeholders
through approaches such as group discussion and community dialogue could go a long
way in increasing delivery in the health facilities thus tremendously lowering mortality
rate for both the baby and the mother which could otherwise occur when the mother
doesn’t get services of a specialized personnel.
References:
[1] Indira,
N., Shaver, T., Clark, P.A, Cordero, D., & Faillace, S., 2004, Entry into this
World: Who Should Assist? Birth Attendants and Newborn Health. Published by the
Basic Support for Institutionalizing Child Survival Project (BASICS II) for the
United States Agency for International Development. Arlington, Virginia.
[2] Wanjira,
C., Mwangi, M., Mathenge, E., Mbugua, G. & Ng’ang’a, Z., 2011, Delivery Practices
and Associated factors among Mothers Seeking Child welfare Services in selected
Health Facilities in Nyandarua South District, Kenya. BMC, Public Health, 11-360.
https://doi.org/10.1186/1471-2458-11-360.
[3] World Health
Organization & United Nations Children’s Fund (UNICEF)., 2010. Countdown
to 2015-decade report (2000-2010) with country profiles: taking stock of maternal,
newborn and child survival. World Health Organization. https://apps.who.int/iris/handle/10665/44346.
[4] World Health
Organization, International Confederation of Midwives & Fédération internationale
de Gynécologie et d’Obstétrique., 2004, Making pregnancy safer: the critical role
of the skilled attendant: a joint statement by WHO, ICM and FIGO. World Health Organization.
https://apps.who.int/iris/handle/10665/42955.
[5] Narahari,
P., Chittaranjan, Adanu R., 2015, The unfinished agenda of women’s reproductive
health. International Journal of Gynecology & Obstetrics. 131. S1-S2. 10.1016/j.ijgo.2015.04.025.
[6] UNICEF.,
2008, Maternal and Newborn health. https://www.unicef.org/health/maternal-and-newborn-health.
[7] UNICEF.,
2009, State of the World’s Children Report. https://www.unicef.org/reports/state-worlds-children-2009.
[8] Apple, MW.,
& Beane, JA., 1995, Democratic schools. Alexandria, VA: Association for Supervision
and Curriculum Development.
[9] Gardner,
H., 1991, The Unschooled Mind. How Children Think and How Schools Should Teach.
New York: Basic Books.
[10] Kenya National
Bureau of Statistics, Ministry of Health/Kenya, National AIDS Control Council/Kenya,
Kenya Medical Research Institute, National Council for Population and Development/Kenya,
and ICF International. 2015, Kenya Demographic and Health Survey 2014. Rockville,
MD, USA: Kenya National Bureau of Statistics, Ministry of Health/Kenya, National
AIDS Control Council/Kenya, Kenya Medical Research Institute, National Council for
Population and Development/Kenya, and ICF International.
[11] Owiti, A.,
Oyugi, J., & Essink, D. 2018, Utilization of Kenya’s free maternal health services
among women living in Kibera slums: a cross-sectional study. The Pan African medical
journal, 30, 86. https://doi.org/10.11604/pamj.2018.30.86.15151.
[12] HERA., 2013,
Health Partners Ghana. Evaluation of the free maternal health care initiative in
Ghana, Accra & Reet.
[13] Zhao, Q.,
Kulane, A., Gao, Y. & Xu, B., 2009, Knowledge and attitude on maternal health
care among rural-to-urban migrant women in Shanghai, China. BMC Womens Health, 9(5).
https://doi.org/10.1186/1472-6874-9-5.
[14] Ahmed, N.,
& Abdel-Rahman, N., 2008, Demographic and socio-economic characteristics of
nomadic population/Sudan fifth census. Khartoum. (non-published report).
[15] Bell, J.,
Sian, L., & Curtis, A., 2003, Trends in Delivery Care in Six Countries. DHS
Analytical Studies No. 7. Calverton, Maryland, USA: ORC Macro and the International
Research Partnership for Safe Attendance for Everyone (SAFE).
[16] Campbell,
O., Graham, W., 2006, Strategies for reducing maternal mortality: getting on with
what works. Lancet, 368: 1284-1299. doi: 10.1016/S0140-6736(06)69381-1. PMID: 17027735.
[17] Oestergaard,
M.Z., Inoue, M., Yoshida, S., Mahanani, W.R., Gore, F.M., Cousens, S., Lawn, J.E.,
& Mathers, C.D., 2011, United Nations Inter-Agency Group for Child Mortality
Estimation and the Child Health Epidemiology Reference Group. Neonatal mortality
levels for 193 countries in 2009 with trends since 1990: a systematic analysis of
progress, projections, and priorities. PLoS Med. 8(8): e1001080. doi: 10.1371/journal.pmed.1001080.
Epub 2011 Aug 30. PMID: 21918640; PMCID: PMC3168874.
[18] 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 Science. 2(5), 864-867. PMID: 22066284.
[19] Pradhan,
A., Aryal, R.H., Regmi, G., Ban, B. & Govindasamy, P., 1996, Nepal Family. Health
Survey 1996. Kathmandu, Ministry of Health, Nepal; New Era; Macro International.
[20] Babalola,
S., & Fatusi, A., 2009, Determinants of use of maternal health services in Nigeria-looking
beyond individual and household factors. Bio Med Central Pregnancy and Childbirth,
9 (43), 1471-2393. https://doi.org/10.1186/1471-2393-9-43.
[21] Gabrysch,
S., & Campbell, O.M., 2009, Still too far to walk: Literature review of the
determinants of delivery service use. BMC Pregnancy Childbirth 9(34), 1471-2393.
https://doi.org/10.1186/1471-2393-9-34.
[22] Manyiwa,
J.S., Yuko O.W. & Opiyo, B.O., 2018, Major Predisposing Factors to Utilization
of Traditional Birth Attendants by Expectant Mothers in Mombasa County, Kenya. Texila
International Journal of Public Health, 6(3), 2520-3134. DOI: 10.21522/TIJPH.2013.06.03.
Art016.
[23] Miltenburg S.A., van Pelt S., de Bruin W., & Shields-Zeeman L., 2019, Mobilizing community action to improve maternal health in a rural district in Tanzania: lessons learned from two years of community group activities. Glob Health Action. 2019;12(1),1621590. Doi: 10.1080/16549716.2019.1621590. PMID: 31190635; PMCID: PMC6566771.