Improving Skilled Birthing: Determinants And Role Of A Maternal-Neonatal Health Intervention Programme In Migori County, Kenya

Abstract

Introduction: Skilled care during pregnancy and delivery is important for the health of both mother and newborn. Integrated maternal health interventions have been found to contribute to improvement in uptake of skilled care during delivery. Methods: An Ex post quasi-experimental design was applied. Among 590 reproductive age women, we assessed the determinants and role of a maternal-neonatal health intervention programme in improving skilled birth attendance (SBA). Tabulation and multivariate logistic analyses was done. Results: The intervention increased SBA (OR= 1.56[95% CI 1.01 to 2.43]).SBA increased from 53.3% to 80.5%. Attending ante-natal care(ANC) and the number of ANC visits were significantly associated with SBA(p=0.000). Having ones’ mother as a birth companion increased the likelihood of SBA(OR= 4.97[95% CI 2.74 to 9.00] p=0.000) as was possession of a mobile phone number (OR= 2.82[95% CI 1.33 to 5.96] p=0.007) while those who had not had any of their under five year olds die in the last two years or referred by a health worker were more likely to take up skilled delivery (OR= 2.76[95% CI 1.25 to 6.08] p=0.012) and (OR= 2.50[95% CI 1.03 to 6.11] p=0.044) respectively.

Being married and contact with a traditional birth attendant (TBA) reduced likelihood of SBA (OR= 0.33[95% CI 0.148 to 0.727]), (OR= 0.055[95% CI 0.005 to 0.595]) respectively. Conclusion: ANC attendances, health education to clients are critical aspects that can enhance uptake of SBA. Policy makers should re-strategize the involvement of TBAs in efforts towards scaling up SBA.