Assessing individual factors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya.

Abstract

Background: Globally, about 295,000 maternal deaths occurred in 2017 with Sub-Saharan Africa and Asia accounting for 86%. Sub-Saharan Africa alone accounted for nearly two-thirds. The rate of skilled birth attendant in Sub-African region stood at 59%. Three quarters of neonatal and maternal deaths occur outside hospital settings. Currently, the rate of maternal mortality in Kenya stands at 362 per 100,000 live births. Despite the deliberate government interventions to increase hospital deliveries, still a significant number of women deliver at home. The objective of this study was to assess the individual actors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya. Methods: This was a cross-sectional descriptive study adopting both quantitative and qualitative data collection methods. A total of 416 postnatal women were systematically sampled from households at a predetermined interval of four. Key informants interviews and focused group discussions provided additional qualitative data.Results: Approximately 56.7% of postnatal women in Marsabit County delivered in health facilities. Most individual factors such as decision maker (p=0.031), myths and misconceptions (p=0.025), reduction of complications (p=0.001), hospital delivery time consuming (p=0.023) and possession of medical insurance (p=0.001) were significantly associated with choice of place of delivery. Conclusions: Approximately 6 out 10 deliveries occur at health facilities in Marsabit County. Individual factors significantly influenced choice of place of delivery. There is need for the ministry of health, County Government of Marsabit and relevant stakeholders to demystify myths and misconceptions about hospital deliveries, scale up awareness on availability of Linda Mama medical cover for pregnant women to ensure easy access of hospital delivery services.