Abstract:
Background:
Improving maternal health is one of th
e UN Millennium Development Goals. We
assessed provision and use of an
tenatal services and delivery care
among women in rural Kenya to
determine whether women were receiving appropriate care.
Methods:
Population-based cross-sectional survey
among women who had recently delivered.
Results:
Of 635 participants, 90% visited the antenatal
clinic (ANC) at least
once during their last
pregnancy (median number of visits 4). Most wo
men (64%) first visited the ANC in the third
trimester; a perceived lack of qua
lity in the ANC was associated wi
th a late first
ANC visit (Odds
ratio [OR] 1.5, 95% confidence
interval [CI] 1.0–2.4). Wome
n who did not visit an ANC were
more likely to have < 8 years
of education (adjusted OR [AOR]
3.0, 95% CI 1.5–6.0), and a low
socio-economic status (SES) (AOR 2.8, 95%
CI 1.5–5.3). The ANC provision of abdominal
palpation, tetanus vaccination and weight measur
ement were high (>90%), but provision of other
services was low, e.g. malaria pr
evention (21%), iron (53%) an
d folate (44%) supplementation,
syphilis testing (19.4%) and health
talks (14.4%). Eighty percent of
women delivered outside a health
facility; among these, traditiona
l birth attendants assisted 42%, laypersons assisted 36%, while 22%
received no assistance. Factors si
gnificantly associated with giving
birth outside a health facility
included: age
≥
30 years, parity
≥
5, low SES, < 8 years of education, and > 1 hour walking distance
from the health facility. Wome
n who delivered unassisted were
more likely to
be of parity
≥
5
(AOR 5.7, 95% CI 2.8–11.6)
