Abstract
Despite numerous campaigns to increase uptake of hospital delivery services in Kenya, skilled birth attendance is still low. The situation is particularly worse for marginalized rural communities, including the Marakwet of western Kenya. Marakwet County ranks far below the national health survey indicators, with only 28% of the women delivering in hospitals compared to the average national index, which is at 62% [1]. Different reasons are cited for the low health facility use by women during delivery. Drawing from a study on determinants of birthing sites conducted among the Marakwet of western Kenya, this paper discusses the socio-cultural factors that influence women's choice of the site of birthing. The study employed both qualitative and quantitative methods of data collection and analysis and it reports the qualitative findings. A total of 186 mothers, selected using multistage cluster sampling, were interviewed. Three focus group discussions with participants ranging from 8-12 were conducted, one with mothers below 20 years of age, another with mothers above 45 years of age and the third one with married men. A total of 29 participants participated in the FGDs. The FGDs participants were separately selected and were outside the 186 sampled informants. The study found that traditional birth attendants, rituals performed in the birthing process, and disposal of the placenta were the critical socio-cultural factors influencing the Marakwet women choice of birthing site. The paper concludes that understanding and addressing these factors is the key to any intervention programs designed to improve the reproductive health of women through the utilization of hospital as a birthing site.
Highlights
IntroductionThis paper discusses the socio-cultural factors that deliver. a long-time tradition in the community of influence women’s choice of the site of birthing
Kenya, this paper discusses the socio-cultural factors that deliver
The healthcare facilities are evenly distributed in the area but a low utilization of hospital delivery services has been a persistent challenge in the area
Summary
This paper discusses the socio-cultural factors that deliver. a long-time tradition in the community of influence women’s choice of the site of birthing. Attendants, rituals performed in the birthing process, and Anthropologist Arthur Kleinman’s explanatory models disposal of the placenta were the critical socio-cultural (EMs) propose that individuals or groups of individuals factors influencing the Marakwet women choice of may have vastly different notions of health and disease. Women’s own knowledge, their social responsibilities, and gender of the health care providers influence the choice of birthing site. An important factor that keeps women away from hospital delivery is the seemingly indiscriminate use of caesarean section to deliver women. Women consider this as unnecessary medicalization of their reproductive life. Birthing among the Akamba is believed to be normal if a woman is allowed to labour since pain endurance is an important element of motherhood and it is a fulfilling experience [8]
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