Abstract:
Objective: To explore barriers to utilization of health-facility-based delivery in Kenya,
use of which is associated with reduced maternal mortality.
Methods: In April 2017, a qualitative study utilizing key informant interviews (KIIs) and
focus group discussions (FGDs) was carried out in Bomachoge-Borabu and Kaloleni,
Kenya. Twenty-four KIIs were performed including health service providers, com -
munity health workers, religious leaders, local government representatives, Ministry
of Health representatives, and representatives of women's organizations. Sixteen
FGDs were held separately with adolescent females, adult females, adult males, and
Community Health Committee members. Data were transcribed, coded, and catego-
rized thematically to illustrate supply-side and demand-side barriers to use of health-
facility-based delivery services.
Results: Supply-side barriers included staff shortages, inadequate supplies and space,
poor interpersonal relations, few trained staff, long distance to services, poor transport
infrastructure, and limited service hours. Demand-side barriers included financial con-
straints, limited spousal support, observance of birthing traditions, limited knowledge
on importance of health-facility-based delivery, and fear of health-facility procedures.
Conclusions: Diverse barriers continue to influence use of health-facility-based de-
livery services in Kenya. Practical, integrated interventions are urgently needed to
reduce barriers noted, to further reduce the maternal mortality rate.
