Differential Effects of Household Characteristics on Uptake of Skilled Birth Attendance among Women of Reproductive Age in Western Kenya

Abstract

Maternal health remains a challenge in developing countries. The number of women dying every year from maternal-related causes has remained high in developing countries despite various efforts to bring them down. Such deaths occur due to complications during pregnancy, childbirth and the postpartum period. Approximately 16–33% of maternal deaths can be averted if supervised by skilled professionals. WHO describes skilled birth attendance (SBA) as skilled care at birth. Great Lakes University of Kisumu (GLUK) supported the strengthening of Community Health Strategy implementation (CHS) in the Western region of Kenya for a period of five years aiming at reducing poor reproductive health indicators among young people and women. The overall aim of this study was to determine the contribution of CHS implementation to maternal and child health, specifically on uptake of SBA. This was an embedded study in a larger study. It was an analytical study utilizing secondary quantitative data drawn from a descriptive cross-sectional study done during the period of GLUK’s intervention. The main objective of this study therefore, was to establish the differential effects of household characteristics on the uptake of SBA among women of reproductive age in the Western region of Kenya. Descriptive statistics were used to determine the uptake level of SBA. Cross-tabulations were done to determine the association between household characteristics and uptake of SBA, where Chi-square was used to test for significance of association at a 5% confidence level. Logistic regression analysis was done to test the strength of association between the variables of interest. Analysis was done using STATA version 14. Findings showed that uptake of SBA was 70%. Trend analysis across ages of the U5-year-old children showed a steady annual increase of 3% in the uptake of SBA over the five-year period from 69% to 77%. Results from Chi-square tests showed that four out of seven Socio-demographic and economic household characteristics had a significant influence on the uptake of SBA (Housing type-P-value=0.000); Age of the Household head-P-value=0.002); Disability-P-value 0.004) and Availability of staple food -P-value=0.000). Gender, education level of the Household head and presence of a latrine had no association. Logistic regression analysis showed that out of the 4 variables with association, only 2 (housing type-P-value= 0.000 and availability of staple food-P-value=0.000) showed significant strength of association