Utilisation of skilled birth attendants among women of reproductive age in Central District, Kitui County, Kenya

Abstract

This is a descriptive cross-sectional study utilising quantitative and qualitative approaches targeting women of reproductive age (15–49 years old). The proportion of deliveries attended by skilled birth attendants (SBA) was at 41.4%. Factors influencing utilisation of SBAs in the study area were: age (χ2=8.65(df=2), p=0.013), religion (Odds Ratio (OR) 3.22, p=0.004), level of education (OR 2.43, p=0.05), partner’s occupation (OR 0.533, p=0.029), parity (OR 0.26, p=0.002), residence (OR 4.07, p<0.0001), type of housing (OR 0.502, p=0.010), house ownership (OR 0.39, p=0.001), number of house occupants (χ2=10.9(df=2), p=0.004), household monthly income (OR 1.73, p=0.018), antenatal clinic attendance (OR 5.6, p=0.025), facility for antenatal clinic attendance (OR 0.388, p=0.001), birth preparedness (OR 0.8, p=0.015), decision to attend antenatal clinics (χ2=7.59(df=2), p=0.022), decision on delivery place (χ2=10.424(df=2), p=0.005) and facility staff’s attitude (OR 5.18, p=0.014). Barriers to utilisation of SBAs included: training of traditional birth attendants (TBA), lack of co-ordinated referral systems, poor and unreliable means of transport, limited infrastructure, and limited number of SBAs. The study sought to find out about utilisation of SBAs in Kitui County, Kenya. The results indicate sociodemographic and economic factors significantly determine utilisation. Various barriers hindered utilisation of skilled birth attendants. In conclusion, ensuring skilled deliveries is only possible in health facility settings. At the same time, this is not practical unless the health facilities are renovated and equipped with supplies and service providers. As per the key informants, there are limited numbers of skilled birth attendants even in the hospitals, the health system lacks infrastructure (means of transport), supplies are limited, the terrain is rocky and there are few retired midwives in the community to offer these services. From the study area, none of the deliveries which took place at home were conducted by a SBA.