Obstacles to utilization of institutionalized delivery care in Kenya: a case study of Teso district

Abstract

This paper examines the factors that underlie the choice of place of delivery among expectant mothers in Teso district, Kenya. Data from surveys carried out in Teso district in 2000 and 2002 indicate that seventy-six percent of 1170 women in the reproductive age who gave birth during the five years preceding the study delivered their babies at home. Traditional birth attendants (TBA) and midwives were the main providers of delivery care. TBAs were regarded as affordable, readily available and respectful to expectant mothers. The constraints to the utilization of institutionalized delivery care proved to be manyfold. The major obstacles included the unavailability or inaccessibility of health facilities, competing priorities of mothers in a male-dominated society, poverty, high user charges and associated costs, aggravated by lack of water and food supplies in most health facilities and relatively low quality of services offered. Reducing or removing these constraints would result in increased utilization of institutionalized delivery care. Bibliogr., note, sum