Determinants of utilization of maternal health care services in Coast Province, Kenya

Abstract

Proper utilization of maternal health care services is a crucial step towards reduction of maternal mortality. This study sought to examine factors that influence utilization of maternal health services by expectant women in Coast province of Kenya which is one of the provinces with high mortality rates. Previous studies in various countries report differentials in use of maternal services according to demographic and socioeconomic factors. The study used secondary data from the Kenya Demographic Health Survey (KDHS) carried out in 2003. There were 699 cases from child file subset used in this study from the province. Maternal health care services considered were assistance during delivery, place of delivery, timing of antenatal check and antenatal care provider. The independent variables considered comprise maternal age, parity, education, marital status, income, place of residence and use of contraceptive methods. Generally, there is low utilization of major maternal health care services in Coast province except for antenatal care wl~ich is widely utilized ,~l~eit late as only about 8 percent of births in this study were from mothers who sought antenatal care in the first trimester of their pregnancy as recommended by health care experts. Further, only 34 percent of births were assisted by a health professional during delivery with 31 percent of the births being reported to have taken place in a health facility. Study findings indicate differentials in use of various maternal health care services among women in Coast province according to demographic, socio-economic and »: exposure factors. Education positively influences utilization of all maternal health care services studied. Women who are more educated are more likely to deliver in a health facility, get assisted by a health professional during delivery and seek antenatal care from a health professional. I J Place of residence and parity of a woman influence the probability of an expectant mother seeking maternal health care services. Results from this study indicate that women who live in urban areas are more likely to use maternity services. Similarly women with few children are more likely to be assisted by a professional during delivery and the likelihood decreases with increase in the number of births. There is a need to increase use of delivery services among women in the province in order to positively influence pregnancy outcomes and eventually reduce maternal mortality. Efforts should also be made to encourage women to seek antenatal care in the first trimester of their pregnancy as only a small proportion of mothers sought the services during the first trimester. This could be done through increased awareness on the benefits that accrue from accessing maternal health care services on time. Further research is recommended to explore some key areas that were not handled in this study due to data, time and financial limitations, It is for instance important to carry out a research to explain reasons for low utilization of delivery services in the province despite high level of utilization of antenatal care. In addition, a study to clearly explain the relationship between maternal mortality and utilization of various forms of maternal health care services such as,.assistance during delivery, place of delivery, timing of first antenatal check and choice of antenatal care provider would be essential.