Introduction:

Delivery by skilled birth attendants SBA improves the outcome of pregnancy during rndelivery and the postpartum period. Focused Antenatal Care FANC aims at providing rnindividualized care to a woman attending ANC and preparing her for delivery

Objectives:

Main rnobjective of this study was to determine the factors associated with choice of place of rndelivery among women attending ANC in Mbooni Sub-County.

Methodology:

Three hundred and rntwenty four pregnant women were recruited to the study in Mbooni Sub-County at rnTawa Kisau and Kikima health facilities which were randomly selected. The research rndetermined how ante natal care individual birth plan and birth preparedness affect rndelivery by skilled attendants and also identified the knowledge attitudes and practices rnKAP of antenatal mothers that are associated with delivery by skilled birth attendants. rnThe participants were followed during ante-natal period up to six weeks after delivery. rnThe health promotion provided during different antenatal visits was recorded while rnknowledge attitudes and practices regarding delivery by skilled birth attendants was rnelicited during six weeks postpartum visit. A questionnaire was used to collect data.

Findings:

Results:

Results of the study indicated that the following variables were significantly associated rnwith choice of delivery by skilled birth attendants age of respondents 20 - 24 years OR rn 1.4 CI: 0.53 - 3.86 P 0.03 25 - 29yearsOR 2.4 CI: 0.87 6.65 P 0.03 high rnschool level of education OR 1.6 CI: 1.02 2.58 P 0.01 College level of rneducation OR 6.9 CI:1.84 26.46 P 0.00 being peasant farmer OR 0.070.015 0.38P 0.01 having a partner of college level education OR 6.1 CI: 1.91 19.93 rnP 0.01 using a vehicle as mode of transport OR 8.1 CI: 3.41 - 19.26 P 0.00 rnand amount of money spent during delivery KShs 5370 CI: 4918.14 - 5822.76 for rnhealth facility delivery versus KShs 2334 CI: 2098.90 - 2570.69.

Conclusion:

There are various potentially modifiable determinants of delivery by skilled birth rnattendants in the rural area of Mbooni Sub-County in Makueni County Kenya. rnObjective on proportion of women attending ANC utilized skilled deliveries rn The utilization of skilled care was above national average but there was still room rnfor increasing utilization. rn Provision of education beyond primary school level for women will enable them to rnmake the wise choice of delivering under skilled care. rn The ANC women should be encouraged to make individual birth plan together with rntheir spouse and birth companions so as to increase utilization of skilled care at rndelivery. rnObjective on effect of socio-demographic characteristics of ANC women on delivery by rnskilled attendants rn The women of higher parity had fewer delivery in health facilities because they tend rnto believe the risk of their pregnancy was reduced by increased parity. Health rnworkers should emphasize to the women of higher parity that every pregnancy has rnrisks and can complicate despite previous pregnancies having being uneventful. rn Husbands of the married women tended to encourage their wives for delivery with rnskilled care compared to mother-in-laws. The birth companions are critical rnparticipants in choice of place of delivery of women attending ANC in Mbooni SubrnCounty. They should incorporated in individual birth plan and asked to attend ante rnnatal clinic to be educated on the need of skilled delivery. rn79 rnObjective on effects of logistics and economic factors on skilled attendance during rndelivery rn Use of a vehicle to place of delivery was significantly associated with utilization of rnSBAs. Transport preparedness to a health facility for delivery can make a difference rnand health officials should consider introduction of community ambulance to rnimprove access to skilled care. rn Amount of money used during delivery by skilled birth attendants was significantly rnhigher than when a woman was attended to by traditional birth attendants. Effort rnshould be made to reduce amount of money spent during labor in the health facility rnbecause mothers are spending an average of Ksh 5370 during such delivery. rnSubsidizing health facility deliveries which has been done by the new government rncan improve the uptake of skilled care. rnObjective on attitude regarding delivery by skilled birth attendants rn Opinion on health workers was negatively associated with choice to deliver in a rnhealth facility with many women who delivered in health facility having negative rnopinion on SBAs. Health workers should be trained on proper care for women rnduring health facility deliveries and good relationship with mothers during labour to rnearn a positive appraisal about their work from the women. rnObjective on knowledge on danger signs in pregnancy childbirth and post-natal period rnamong the women rn All danger signs in pregnancy have not been taught to ANC women so as they can rnknow the risks that can ensue in pregnancy. Such areas as febrile illness and signs of rnelevated blood pressure in pregnancy should be emphasized because at the moment rnthey are least recognized as danger signs.

Author(s):

Focus County(s):

Makueni County

Programme Area(s):

Sexual, Reproductive, Adolescent & Child Health

Research Priority Area(s):

Disease Domain(s):

maternal Health

Publication Date: 17.Jul.2019

Conference Title:

Venue: