Factors associated with maternal decision against hospital delivery despite ANC attendance in Kakamega central sub county

Abstract

Despite a large proportion of woman attending ANC during pregnancy, a significant percentage still avoid delivering at the health facility. This increases the risk of adverse pregnancies outcomes and deaths. Knowledge of factors associated with the decision against health facility delivery is limited. The main objective was to describe health facility factors associated with maternal decision against despite ANC attendance in Kakamega Central Sub-County. A community based cross sectional study was undertaken focused on a structured interview method in collecting quantitative data. Sample of 332 mothers who attended ANC but did not deliver in a health facility were drawn from a study population. A multistage random sampling method was applied in the selection of a primary data. Factors that made mothers to decide against health facility delivery despite ANC attendance included costs of transport and lunch, lack of supplies and commodities and lack of sufficient preparatory service for delivery emerges as more crucial determinant for decision against health facility. Chi-square tests were used describe single variables and to assess associations between variables. The statistical significance level was set at p<0.05. Income source of the women were also associated with the perception on all staff always being available at the facility. We found significant associations between costs, and other costs. Availability of different levels of health facility will not alone solve the problem of low health facility delivery rates. These facilities need to be equally empowered with supplies, staffs who can give quality comprehensive service. Furthermore the women need to be economically empowered to be able to meet other costs like transport and lunch. Focus on increasing financing for maternity service by the government and intersectoral approach for maternal health is crucial in Kakamega Central Sub County. The county government should provide ambulance services for pregnant women, decentralization of delivery services in all health facilities and provide with staffs, supplies and commodities for equity of usage of delivery services, improved road network. Need for constructive and collaborative approach to promote maternal health and need to multi-sectoral approach to overcoming the barriers to health facility deliveries.