Utilization of maternity waiting homes in West Pokot County, Kenya

Abstract

Introduction: The aim of this study was to examine the utilization of maternity waiting homes in West Pokot County, Kenya. Maternity waiting home improves obstetric outcomes like increased access to skilled deliveries and reduction of maternal morbidity and mortality rates in low-income countries like Kenya and Malawi. Many deaths are due to complications associated with unskilled deliveries at home with no skilled care. The study focused on utilization of maternity waiting homes in West Pokot County, Kenya. Objectives: To determine factors associated with utilization of maternity waiting homes in West Pokot, to assess awareness and experiences of mothers towards maternity waiting homes and to examine relationship between utilization and maternal and neonatal outcomes. Methods: A survey design and stratified random sampling technique was adopted to carry out the study. A sample of 725 mothers was selected in post-natal wards of 3 health facilities. Data was collected using researcher administered structured questionnaires. Descriptive statistics such as measures of central tendency and measures of variability were used to summarize numerical data such as distance to health facility and maternal age. Categorical data such education level, marital status and level of utilization were summarized as frequencies and proportions. Likert scale was used to assess mothers experiences towards Maternity Waiting Homes (MWH). Results: MWHs utilization rate in Kepenguria was 15.5%. There was a significant association between MWHs utilization and monthly income than those who did not use MWHs U(n=445) = 5.17, p<0.001. There was a significant association between utilization and occupation χ2(2, n=722) = 8.22, p<0.016). Those self-employed utilized MWHs more (19.1%) compared to government employees (13.2%) and those unemployed (9.5%).. Most of the residents had not heard about MWHs(64.4%). Among those who had knowledge about MWHs, fifty percent heard about it from the health care professionals and very few from the media (1%). The study showed that mothers who utilized MWHs recorded good maternal outcomes compared to those who did not utilize MWHs. The study results revealed that 1.1% mothers who utilized MWHs recorded poor maternal outcomes compared to 7.3% who did not utilize the MWHs. Conclusion: There was low utilization of MWHs which is affected by monthly income and occupation. Most respondents had little knowledge about MWH. The study also established that there is an association between MWHs utilization and maternal, neonatal outcome. Unless community awareness increases, knowledge of preventive maternity care improves, and barriers preventing their use are overcome, MWHs will continue to be underutilized. Recommendations: Concerted efforts must be undertaken to promote and tackle both the socio-economic, maternal and hospital associated factors hindering their utilization. There is still a need for the Ministry of Health in West Pokot County to create awareness among community to embrace the utilization of Maternity Waiting Homes. County government should invest more on health education of the mothers as it is important during birth preparedness and reduction of dangers associated with pregnancy, child birth, postpartum period and importance of hospital delivery.