Introduction:

Since independence the Government of Kenya has made lots of efforts to reducernmaternal mortality and morbidity through some women-oriented programs. Thesernprograms are included in the marginalized groups like Ogiek in Mt. Elgon Constituencyrnin Bungoma County. Despite this Mt. Elgon constituency in Bungoma County still hadrnhigh maternal mortality and morbidity together with low utilization of maternal healthrncare services. Reports showed low levels of skilled delivery in Mt Elgon Constituencyrn28 compared to Bungoma County 41 and nationally 60 in the year 2015.

Objectives:

Thernstudy investigated the determinants of maternal health care service utilization amongrnmothers of Mt. Elgon constituency in Bungoma Kenya. Specifically to determine thernclients characteristics examine health facility factors and determine the culturalrncompetence of health care workers and their relationship with maternal health carernservice utilization in the study area.

Methodology:

A descriptive-analytic cross-sectional study wasrnadopted using a mixed method of data collection. A total of 510 respondents werernrandomly selected using a multistage cluster sampling method and were interviewedrnfrom January to March 2019. Data on participants characteristics health facility factorsrnand cultural competence of health care workers were collected with structuredrnquestionnaires. Quantitative data was collected from staff using a self-administeredrnquestionnaire while caregivers were interviewed using an interviewer-assistedrnquestionnaire. Cultural competence tool was used to assess health care workers culturalrncompetence. Qualitative data was collected using key informant interviews KII andrnfocus group discussion FGD. Data entry and analysis was done using SPSS version 25rncomputer software. Both descriptive and inferential statistics were used for analysis.

Findings:

Results:

A total of 20 health workers were interviewed and their data analyzed 100. There were more males in Mt. Elgon 69.2rnand Cheptais 57.1 than females. Most of the respondents were younger 20 29rnyears old in Mt. Elgon 38.55 and Cheptais 42.9. The mean age was comparablernwith a slight difference in Mt. Elgon 34.68.3 compared to Cheptais 33.76.2. Thernmajority of the participants in Mt. Elgon 69.2 and Cheptais 85.7 were married.rnSimilarly over three-quarters in both sub-counties were Christians. The leading ethnicrngroup in Mt. Elgon 38.5 and Cheptais 71.4 were Sabaots. Professional characteristics of staff by sub-county. Over one-thirdrnin Mt. Elgon 38.5 and Cheptais 71.4 were nursing officers. Most of the staff hadrnworked for more than 12 months.rnHealth workers were asked 11 questions to assess their level of cultural awareness aboutrnthe communitys demographics. The questions covered knowledge in the communityrnwhere they work. The result revealed that most of the staff in Mt. Elgon 84.6 andrnCheptais 85.7 could describe the community by tribes in the service area very well.rnSeventy-seven percent from Mt. Elgon and 71.4 from Cheptais were could describernwithin tribe differences very well. Over two-thirds in each sub-county could describernwithin tribe strengths and tribe social problems very well. Items with poor performancernincluded knowledge by tribes unemployment rates 28.6 differences in incomerndifferentials and birth and death rates were less than 70 of the respondents knew veryrnwell.rnParticipants were asked 8 questions on their knowledge on community gatekeepers in thernservice area . There was comparatively higher knowledgernamong staff in Mt. Elgon 84.6 and Cheptais 85.7 and on the tribes businessrnpeople for the former 76.9 and the latter sub-county 71.4 respectively. Thernpoorest performance was on knowledge on tribes advocates were 46.2 of the staff inrnMt. Elgon and 28.6 in Cheptais knew very well. Equally knowledge of social servicernagency was barely understood among staff in Mt. Elgon 46.25 and Cheptais 42.9.rnThe highest proportion of staff from Mt. Elgon 84.6 and Cheptais 85.7 knew therntribes formal leaders very well.rnNotably overrnthree-quarters in both the two sub-counties knew very well the tribes area needs arearnlanguages and the tribes non-utilization of maternal health care views. However thisrnwas not the case with staff from Cheptais 28.6 compared with those from Mt. Elgonrn84.6 where the proportion of those who knew very well the tribes beliefs customsrnnorms and values was very low.rnThere was a higher level of interaction in the local area involvement in the communitysrnforum /neighborhood meetings attendance and safety matters. In these three areas morernthan two-thirds of the respondents often participate. However staff seldom gets involvedrnin businesses owned by community members as shown by a lower proportion for Mt.rnElgon 38.5 and Cheptais 28.6. Staff in Cheptais 85.7 more often attendrncultural functions compared with their colleagues from Mt. Elgon 46.2.

Conclusion:

The evidence from this study demonstrates that the client characteristics is a determinantrnof maternal health care services utilization specifically the age of lower than thirty yearsrnmothers who do not work mothers who have stayed less than six months in Mt. ElgonrnSub County and mothers with a low level of education that is none or primary education.rnHealth facility factors that are determinants of maternal health care services utilizationrnamong mothers in Mt. Elgon Constituency in Bungoma County are the time taken tornreach a facility by foot payment of ANC services use of an interpreter and waiting forrntime.rnThis paper offers important and quite educative and very challenging results concerningrnthe cultural competence of health care workers. It is concluded that all the health carernworkers in Mt. Elgon constituency were incompetent culturally and this affects thernuitilization of maternal health care services in the study area.

Author(s):

Focus County(s):

Bungoma County

Programme Area(s):

Sexual, Reproductive, Adolescent & Child Health

Research Priority Area(s):

Disease Domain(s):

maternal Health

Publication Date: 15.Aug.2020

Conference Title:

Venue: