Abstract
BackgroundThe North Eastern region in Kenya experiences challenges in the utilization of maternal and newborn health services. In this region, culture and religion play a major role in influencing healthcare seeking behaviour of the community. This study was conducted to (i) understand key inherent barriers to health facility delivery in the Somali community of North Eastern Kenya and (ii) inform interventions on specific needs of this community.MethodsThe study was conducted among community members of Garissa sub-County as part of a baseline assessment before the implementation of an intervention package aimed at creating demand and increasing utilization of maternal and newborn services. Focus group discussions and key informant interviews were conducted with clan leaders, Imams, health managers, member of the county assembly, and service users (women and men) in three locations of Garissa sub-County. Data were analysed through content analysis, by coding recurrent themes and pre-established themes.ResultsUsing health facility for delivery was widely acceptable and most respondents acknowledged the advantages and benefits of skilled birth delivery. However, a commonly cited barrier in using health facility delivery was the issue of male nurses and doctors attending to women in labour. According to participants, it is against their culture and thus a key disincentive to using maternity services. Living far from the health facility and lack of a proper and reliable means of transportation was also highlighted as a reason for home delivery. At the health facility level, respondents complained about the poor attitude of health care providers, especially female nurses being disrespectful; and the limited availability of healthcare workers, equipment and supplies. Lack of awareness and information on the importance of skilled birth attendance was also noted.ConclusionTo increase health facility delivery, interventions need to offer services that take into consideration the sociocultural aspect of the recipients. Culturally acceptable and sensitive services, and awareness on the benefits of skilled birth attendance among the community members are likely to attract more women to use maternity services and thus reduce adverse maternal and newborn health outcomes.
Highlights
The North Eastern region in Kenya experiences challenges in the utilization of maternal and newborn health services
Globally, maternal and child survivals had significantly improved over the Millennium Development Goals (MDGs) era in 2015, with global trends showing marked improvements in maternal and child health indicators [1]
Gender of service provider Preference of female over male service providers came out strongly as a key barrier in using maternity services which are often provided by male nurses and doctors
Summary
The North Eastern region in Kenya experiences challenges in the utilization of maternal and newborn health services. In this region, culture and religion play a major role in influencing healthcare seeking behaviour of the community. Maternal and child survivals had significantly improved over the Millennium Development Goals (MDGs) era in 2015, with global trends showing marked improvements in maternal and child health indicators [1]. Despite this progress, maternal and neonatal deaths are still high in Sub-Saharan Africa (SSA) and South East Asia. Efforts for better performance under the Sustainable Development Goals (SDGs) era have to target and bring on board vulnerable subpopulations who face unique challenges in accessing and using health services [3]
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