Assessment of social economic factors on the access of maternal and child health services, A case of Laini Saba, Kibera, Nairobi County, Kenya

Abstract

Background: Access to health services and the quality of care administered at all levels of health care have been considered as the central determinants of health outcomes. Efforts to eliminate inequalities in the access of basic health care services have been emphasized for the overall improvement of health in developing countries through the Ministries of Health and globally the World Health Organization. In 2013 the Government of Kenya enforced a policy for free maternal health services across all government healthcare institutions in its quest to reduce maternal morbidity and mortality rates and to improve the survival rates of their children in a run up to the attainment of SDG 3. Objective :To assess the role of social economic factors (maternal occupation, education and income) among women of reproductive ages 15-49 living in Laini Saba of the Kibera, Nairobi County Urban-informal settlement in accessing maternal child health services. Methodology: The study was a descriptive cross sectional study in which a total of 272 women were randomly sampled. An interviewer administered semi structured questionnaire was used for data Collection. Data analysis was performed using SPSS version 20 and a Chi- test at 95% CI was used to test significance of associations. Data was presented in prose, tabular and graphical form. Results: Of the 272 respondents, 115(42.32%) had primary education and over a third 101(37.3%), had a secondary education and 45(16.62%) with tertiary level of education. Unemployed women were 101(38.5%) while 88(33.6%) were self employed and the employed were 73(27.9%). The average income per month was KES 5,890.40 and the mode was KES5, 000. A p < 0.001 showed that there was a significant difference in the different levels of education and income. The minimum amount of money spent on healthcare per month was KES 50 and the maximum KES 30,000 with a mean of KES 989.20. Participants who reported to access maternal child healthcare services were 100 (36.6%) while 172 (63.4%) did not. A p<0.018 revealed that level of education was statistically significant in relation to healthcare access. Consequently a p<0.055 for time spent to access the service and that for income at p>0.137 were found not to be statistically significant. Conclusions: The study revealed that there was a significant association between education and access, while there was no associated significance between income and access contrary to the perception that income plays a major role in the access of healthcare. The nature of occupation also did not reveal any relationship with access to healthcare services. Recommendations: The Kenyan government through the Nairobi county government should step up its efforts to ensure that the necessary infrastructure (road network, easily accessible public health centers with affordable services) are available in slum urban settlements. Additionally the livelihood of the women could be improved through creation of employment and self-sustenance programs and projects in this setting.