Perspectives in women reproductive health decision making among mothers delivered in Kenyatta National Hospital and Pumwani Maternity Hospital

Abstract

ABSTRACT To establish the perspectives in women's reproductive health decision making among mothers delivered in Kenyatta National Hospital and Pumwani Maternity Hospital.The study adopted a descriptive cross sectional research design. Three hundred and eighty four women presenting to the study facilities for delivery were recruited. Mothers who had delivered were interviewed using a semi-structured questionnaire that collected information on socio-demographic and cultural characteristics, women's role in reproductive health decision making including prevention of HIV/AIDS transmission, health care factors influencing women's reproductive health decision making, and perception ofmen's role in women's reproductive health decision making. Systematic random sampling was used to select the study subjects. There being 20 deliveries in KNH and 60 deliveries in Pumwani per day, a ratio of 1:3 were obtained. The sample for KNH was 96 mothers while that of Pumwani maternity hospital were 288. On the first day, all mothers who had been admitted were serialized using the admission book and their numbers subjected to the table of random numbers to select the first subject. Thereafter, every fourth consenting mother was administered to a questionnaire till the required sample size was achieved. Three focus group discussions were conducted one in KNH and two in Pumwani maternity hospital to stimulate richer responses thus obtaining in-depth information. Data obtained was processed and analyzed using SPSS. Chi-square was used to test the results at 0.05 level of significance. the study revealed that age, marital status, level of education and employment status plays a major role in women reproductive health decision making. Some cultural factors found to influence decision making include polygamy, FGM, wife inheritance, sex of baby (preference for boys) and dowry. Female circumcision is a practice that is done forcefully. Some women were in agreement with wife inheritance because some widows do not have any source of income and the only way for her to earn a living is through inheritance. Decision on sexual practice was influenced by many factors. There was significant statistical association between age, marital status, and level of education, income range and planning of pregnancy. Some women initiate sexual intercourse at an early age. Women do not have a chance to choose a marriage partner due to financial constraints. The choice of hospital for delivery depends on services offered and financial capability. Decision on family size is done by the man on many occasions even though some women left decision to super power. Family planning utilization is still low among women. Health services entail service provision and educating women thus influencing their reproductive health decision making. Male partners were found to have a negative influence even though some men were already participating positively in women reproductive health decision making. Women were found not to be able to make decisions on mYI AIDS preventive measures. There is evidence that women are increasingly making decisions influencing their reproductive health, though much needs to be done to empower them. There is need for policies favoring women to be put in place and the government needs to put more effort in educating women on their rights