Factors Influencing Utilization of Antenatal Care Services Among Teenage Mothers in Malindi Sub-County Kenya-A Cross Sectional Study

Ndambuki Stephen Mulinge

doi:10.11648/j.sjph.20170502.12

Abstract

Effective antenatal care services (ANC) present an opportunity to minimize the high risk for poor perinatal outcomes and other birth complications associated with teenage pregnancy. With the failure by Kenya and majority of the Sub Saharan Countries to achieve the Millennium Development Goals (MDG 4 & 5), there is need to understand factors influencing utilization of maternal health services among special groups within the reproductive age. Therefore, this study identified factors that influence utilization of ANC services among women aged 13-19 years. A facility-based cross-sectional study was conducted among 385 teenage mothers using semi-structured questionnaires and key informants’ interviews in Malindi Sub-County. The WHO recommendation of at least 4 ANC visits was used as standard measure for good or poor ANC services utilization. Quantitative data were analyzed using descriptive statistics, chi square test and logistic regression at the 5% level of significance while qualitative data were analyzed thematically. Mean age of the participants was 18.10 ± 1.11 and about 69% were married. In total, 91.2% of the participants reported poor utilization of ANC services with less than 4 ANC visits. About 54.7% reported late/inappropriate booking time. Knowledge of the recommended ANC visits, marital status, occupation, and the person making the decision to attend ANC were strong determinants of ANC utilization. Participants with good knowledge of the recommended ANC visits were about 3 times more likely to have good utilization of ANC services than participants with poor knowledge (OR=2.734, p=0.006, 95% CI: 1.34, 5.58).Participants who made the decision to start ANC clinics were 3 times more likely to have good ANC services utilization compared to participants whose decision was made by others (OR=2.914, p=0.009, 95% CI: 2.91, 6.48).Utilization of ANC services among teenage mothers remains significantly poor in Malindi sub-County. Immense efforts should be directed towards creation of awareness about ANC and its importance in the communities, and implementation of innovative programs targeting pregnant teenage girls to encourage them to seek ANC services.

Highlights

Teenage pregnancy and its associated complications pose a major challenge in efforts to address maternal, infant mortality and related morbidities in Sub-Saharan African countries
As the problem of teenage pregnancy continues to persist in most sub-Saharan countries, significant effort is needed to ensure improved access to maternal health services such as antenatal care
The study established that majority of the teenage mothers attend at least one antenatal care services (ANC) visit but report less than the recommended 4 ANC visits during their pregnancy

Summary

Introduction

Teenage pregnancy and its associated complications pose a major challenge in efforts to address maternal, infant mortality and related morbidities in Sub-Saharan African countries. Majority of Sub-Saharan African countries including Kenya have fallen short of attaining Millennium Development Goals (MDG) and MDGs 4 and 5 targets [17]. Maternal deaths in Kenya were estimated to be about 362 deaths per 100,000 live births by 2014 with large disparities existing across the country with Mandera County reporting extremely high maternal mortality ratios of over 3000 deaths per 100,000 live births [2]. WHO estimates that about 16 million adolescent women give birth each year across the globe with about 95% of these births in the developing countries [1]. Strong research-based evidence depicts poorer perinatal outcomes such as preterm births, early neonatal deaths, stillbirth, low birth weight (LBW

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Discussion

Conclusion