Factors associated with utilization of hospital deliveries at Garissa Provincial General Hospital

Abstract

Low skilled delivery is associated with high MMR (Lawson et al, 2003). NEP has the highest maternal mortality and lowest skilled deliveries in Kenya (KDHS, 2008). ANC attendance is high both nationally and in NEP. This research determines factors associated with utilization of hospital deliveries at Garissa PGH. A cross-sectional descriptive study using mixed methods was conducted. Survey questionnaires/FGD guide were administered to women attending MCH as well as those admitted in the maternity ward. A total of 431participants were randomly selected and interviewed. 3 FGDs conducted on separate days. Data analysis was conducted using SPSS version 17.0. Descriptive statistics were used to summarize categorical/continuous variables and Pearson’s Chi-square test and Binary logistic regression done to test the strength of association and to identify confounders, respectively.

The finding of the study reveal that among the factors studied, age, none existence of cultural/religious beliefs, previous history in delivering at PGH and distance were associated with utilization of hospital delivery at PGH Garissa. No association was found between using antenatal clinic at PGH Garissa and delivering at the same hospital. Staff attitude were appreciated positively, though client raised major complaints.. Majority of women were making their own decision on where they will deliver. Cultural or religious beliefs were not identified as barriers to women’s utilization of the maternity services.

In conclusion, age, none existence of cultural/religious beliefs, previous history in delivering at PGH Garissa and distance were the only factors associated with utilization of hospital delivery at PGH Garissa. The role of health education at ANC to transit pregnant women to deliver in the hospital is not clear. It recommends the hospital administration to ensures health staff are responsive to the needs of the clients while leveraging on the popularity of the hospital. The quality of health education at the ANC should be re-assessed and improvements instituted. Further research is also recommended to study perception of clients not using PGH Garissa maternal and child health services.