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.