Health Facility Factors Associated with Low Birth Weight among Neonates at Thika Level Five Hospital in Kiambu County, Kenya.

Abstract

Purpose: To assess the health facility factors associated with low birth weight at Thika Level Five Hospital in Kiambu County, Kenya. Methodology: Cross sectional convergent design was employed. The target group composed of mothers who delivered in the hospital during the study period (July-August, 2019). A sample was obtained from all willing mothers. Sample size was determined using the Cochran formula assuming a proportion (p) of 16.4% of low birth weight. Desired sample size was 210 mothers which was adjusted to 215 participants. Independent variables included: medical equipment and supplies, medical personnel and accessibility of health facility. Dependent variable was LBW which was classified further as very LBW, extremely LBW. The primary focus was first to identify LBW which was then categorized according to the standard classification. Quantitative and qualitative data were collected and analyzed using logistic regression and NVivo respectively. Findings: Accessibility to a health facility OR= 0.45, p=0.04, CL [0.21-0.97] was associated with very low birth weight. The mothers (FGDs) indicated that there were challenges at the laboratory; some health workers were not good; and ANC counselling sessions were inadequate. Health workers who were Key Informants (KI) reported inadequacy of resources and suggested campaigns to reach mothers in order to attend ANC early and a provision of a preconception centre at the Hospital.   Unique contribution to theory, practice and policy: Inaccessibility of a health facility by pregnant mothers is a risk factor for very low birth weight neonates. ANC guidelines to be revised to cater for the concerns of mothers. Preconception centres should be established in hospitals.