Correlates of Utilization of Skilled Maternal Health Services in Siaya County, Western Kenya

CORRELATES OF UTILIZATION OF SKILLED MATERNAL HEALTH SERVICES IN SIAYA COUNTY, WESTERN KENYA. Obinge Elizabeth Omondi1, 3, Asito Stephen Amolo2 Department of Public Health, School of Health Sciences, Jaramogi Oginga Odinga University of Science and Technology1, Department of Biological Sciences, School of Biological and Physical Sciences, Jaramogi Oginga Odinga University of Science and Technology2, Department of Health, County Government of Siaya 3 *Current address Jaramogi Oginga Odinga University of Science and Technology, P. O BOX 210-40601, Bondo, Kenya * Corresponding author Obinge Elizabeth Omondi Email addresses 1. lizomondi2012@gmail. com 2. jakogwanjo@gmail. com Background Evidence suggests that antenatal care, skilled attendance at birth, postnatal care and continuum of care are key factors in reducing the risk of maternal death. However, in counties such as Siaya County, utilization of skilled maternal health services has remained low with high maternal morbidity and mortality from preventable conditions. Hence this study aimed to assess the correlates of utilization of skilled maternal health services in Siaya County in western Kenya. Methods baseline study was carried out in Siaya County involving a total of 517 pregnant women who had given birth at least once prior to the study period and had the experience of. The correlates were identified using binary and multivariate logistic regression. Results Those who received at least one antenatal care visit were 84.9 %, skilled delivery were 55.7 % while only 23.6 % received post-natal care within 48 hours of delivery. Of note was that only 53.2 % received the WHO recommended 4 ANC visits. This study also revealed that those with no source of income (aOR=0.96, 95 % CI 3.218.27) and farmers (aOR=0.37, 95 % CI 7.326.74) were less likely to utilize maternal healthcare services relative to traders/self-employed and salaried. Women with secondary (aOR=2.62, 95 % CI 4.334.58) and tertiary (aOR=1.43, 95 % CI 2.874.63) education were more likely to utilize maternal healthcare services relative to those with no education and those with primary education. Similarly, women whose husbands had no education (aOR=0.89, 95 % CI 2.071.60) or had primary education (aOR=0.89, 95 % CI 2.071.60) were less likely to utilize maternal healthcare services relative to those whose husbands had secondary or tertiary level of education. Those who walked (0.91 (1.62-2.88) or used bicycle 0.84 (1.69-2.02) were less likely to utilize skilled maternal health services compared to those who used motorbike or private car. The study also revealed that some households (15.3 %) had never been visited by a community health volunteer (CHV) which is an indication of disconnect in the continuum of care. Conclusion Having no source of income, being a farmer, low education, husband/ partners education and walking or using a bicycle to hospital were significantly associated with low utilization of skilled maternal health services. A well designed performance evaluation system is important in ensuring that CHVs visit all the households assigned to them and that they deliver their tasks appropriately. Hence programs targeting increased utilization of skilled maternal health services needs to address these barriers.