Maternal Vulnerabilities and Disparities in Availability of Antenatal Care Content in Kenya: Analysis of KDHS 2008/9

Collins Otieno Asweto,James Ouma

doi:10.12691/ajphr-5-4-4

Abstract

Background: ANC provides the opportunity to detect and treat anomalies of pregnancy and access to preventive maternal and child healthcare. However, detailed information about the actual quality and content of ANC in practice is scanty, especially in developing countries. We analyzed the pattern and content of antenatal care service in Kenya in order to assess the quality of ANC. Methods: We used data from the 2008/9 KDHS, a nationally representative survey of women aged 15-49 years in Kenya. Proportion was used for description purpose while association was determined by bivariate and multivariate analysis in which odds ratio with a 95% confidence interval values were calculated. Results: About 50.9% of women sought ANC services either in health centers or dispensaries but these lower level health facilities had more content gaps. Multivariate analysis indicated that maternal age, regional residence, urban residence, wealth index, education and the media influenced ANC initiation and at least 4 ANC visits. There was a coverage gap existing in terms of iron-folate supplementation (66.1%), tetanus toxoid (66.5%), presumptive/preventive treatment for malaria with SP (38.7%) and education on pregnancy complication (44.3%). Nearly a third of women missed the screening for complication during pregnancy. Conclusion: Disparities exist in provision of ANC components, by type of facility attended, rural-urban and low versus higher income biases. Consequently vulnerable women attending ANC miss important care including screening for complication during pregnancy and labor. Efforts should be designed to improve on supplies to government health centers and dispensaries. Well stocked outreach village clinics with the requirements of a comprehensive antenatal care resource allocation should be used to eliminate service disparities. Government policy should help to increase media penetration amongst the masses and sensitize mothers on the importance of ANC.

Highlights

800 women die every day globally from preventable causes related to pregnancy and childbirth [1]
The study shows that both Antenatal care (ANC) initiation and having at least 4 ANC visits varies with maternal age, region of residence, urban residence, wealth index, education and the three forms of media
Our study shows that a handful of women sought ANC services in government health center or dispensary which are geographically accessible to most rural communities in Kenya, while a third of women sought ANC services in the government hospital, and only 1 in every 5 women used either private or faith based health facility

Summary

Introduction

800 women die every day globally from preventable causes related to pregnancy and childbirth [1]. In 2010, about 287,000 women died worldwide during and following pregnancy and childbirth [1,2] Though this is a decline of 47% from the 1990 level, it is still far from the 2015 Millennium Development Goal (MDG). Despite proven interventions that could prevent death or disability during pregnancy and childbirth, maternal mortality remains a major burden in many developing countries. We analyzed the pattern and content of antenatal care service in Kenya in order to assess the quality of ANC. Results: About 50.9% of women sought ANC services either in health centers or dispensaries but these lower level health facilities had more content gaps. Vulnerable women attending ANC miss important care including screening for complication during pregnancy and labor.

Objectives

Methods

Results

Discussion

Conclusion