1/7/2014

1
•
•

Presenter: Joyce Cheptum
Session: MDGs - Progress made and lessons:
MNCH
Canadian Conference on Global Health

•

•

This program has received financial support from MAISHA
project.

Potential fo...
DEDAN KIMATHI UNIVERSITY OF TECHNOLOGY
A DFATD funded maternal – infant health project
A collaboration of Dedan Kimathi University of
Technology - KENYA and Coll...






Estimated 150,000 women in Africa and
7,700 in Kenya die each year from causes
related to pregnancy and childbirt...






In Kenya, many deliveries take place in the
villages.
According to KDHS 2008-09, 44% deliveries
occur under skill...






Infant mortality in Nyanza is 95 per 1000 live
births (KDHS 2008-09).
The immunization coverage is 51.6% lower
th...




Maternal and newborn health are closely
linked.
Access and utilization of maternal health
services in the health fac...


To identify barriers to access and utilization
of maternal and infant health services.

1/7/2014

10






A cross sectional study design employing
qualitative and quantitative methods,
Study population - women of reprod...








446 women interviewed
Mean age was 25.9 years.
Most women were multiparaous 316 (65.7%)
Average number of ch...
ANC non-attendance Odds Ratio

P>|z|

[95% Conf. Interval]

No. of Pregnancies

0.86

0.025

0.7543 0.9817

Religion

0.76...
Place of delivery

Odds Ratio

P>|z|

[95% Conf. Interval]

No. of Pregnancies

0.82

0.000

0.7589 0.9033

Marital status...
PNC attendance

Odds Ratio

P>z

[95% Conf. Interval]

Age

0 .90

0.001

0.8521 0.9580

No. of Pregnancies

1.21

0.013

...




“Fathers should not see where the child is
coming from because the husband may not
go in again” (FGD - women)
“Fathe...




“There is inadequate staff and equipment
especially Reproductive Health equipment
(delivery and infant resuscitation...
•

•

•

Barriers to access and utilization of maternal and
infant health services in the rural areas could be
attributed ...


Access and utilization of maternal health
services is a hindered by socio-economic,
socio-cultural and health facility ...




Addressing the several barriers hindering
access and utilization of maternal and infant
health services is a step to...







DFATD Canada for funding
College of the Rockies - Moritz Schmidt and
team
Dedan Kimathi University of Technolo...
1/7/2014

22
1/7/2014

23
Thank
You
1/7/2014

24
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Barriers(1) joyce

  1. 1. 1/7/2014 1
  2. 2. • • Presenter: Joyce Cheptum Session: MDGs - Progress made and lessons: MNCH
  3. 3. Canadian Conference on Global Health • • This program has received financial support from MAISHA project. Potential for conflict(s) of interest: – There is no conflict of interest.
  4. 4. DEDAN KIMATHI UNIVERSITY OF TECHNOLOGY
  5. 5. A DFATD funded maternal – infant health project A collaboration of Dedan Kimathi University of Technology - KENYA and College of The Rockies -CANADA Authors: Cheptum JJ, Gitonga MM, Mutua EM, Mukui SM, Ndambuki JN and Koima WJ 1/7/2014 5
  6. 6.    Estimated 150,000 women in Africa and 7,700 in Kenya die each year from causes related to pregnancy and childbirth (ROK, 2010). More than 3 million newborn babies die every year. (WHO, 2012) Children in sub-Saharan Africa face the highest risk of mortality (UNICEF, 2009). 1/7/2014 6
  7. 7.    In Kenya, many deliveries take place in the villages. According to KDHS 2008-09, 44% deliveries occur under skilled birth attendance. Kenya yet to achieve the MDG 4 and 5. 1/7/2014 7
  8. 8.    Infant mortality in Nyanza is 95 per 1000 live births (KDHS 2008-09). The immunization coverage is 51.6% lower than Kenya’s 75% (District Health Statistics, 2012). Migori County - health facility deliveries is 32.5% and skilled birth attendance is 35.1% (KNBS, 2012). 1/7/2014 8
  9. 9.   Maternal and newborn health are closely linked. Access and utilization of maternal health services in the health facilities has been linked with improved maternal and neonatal health outcomes, 75% of maternal deaths can be prevented (Babalola, 2009, WHO, 2001). 1/7/2014 9
  10. 10.  To identify barriers to access and utilization of maternal and infant health services. 1/7/2014 10
  11. 11.    A cross sectional study design employing qualitative and quantitative methods, Study population - women of reproductive age (15 – 49 years) and men. Researcher - administered questionnaire, Key Informant Interview and FGD were used. 1/7/2014 11
  12. 12.       446 women interviewed Mean age was 25.9 years. Most women were multiparaous 316 (65.7%) Average number of children per woman was four. Primary level of education - 357(80%) Most of the respondents did not have a formal employment – 415 (93%). 1/7/2014 12
  13. 13. ANC non-attendance Odds Ratio P>|z| [95% Conf. Interval] No. of Pregnancies 0.86 0.025 0.7543 0.9817 Religion 0.76 0.026 0.5906 0.9670 Education level 1.77 0.018 1.1036 2.8300 Occupation 0.06 0.005 0.7094 0.9409 1/7/2014 13
  14. 14. Place of delivery Odds Ratio P>|z| [95% Conf. Interval] No. of Pregnancies 0.82 0.000 0.7589 0.9033 Marital status 1.51 0.003 1.1468 1.9835 Education level 1.67 0.029 1.0554 2.6499 Occupation 0.83 0.007 0.7185 0.9489 1/7/2014 14
  15. 15. PNC attendance Odds Ratio P>z [95% Conf. Interval] Age 0 .90 0.001 0.8521 0.9580 No. of Pregnancies 1.21 0.013 1.0403 1.3969 Education level 1.48 0.113 0.9110 2.4029 Occupation 1.19 0.029 1.0180 1.3951 1/7/2014 15
  16. 16.   “Fathers should not see where the child is coming from because the husband may not go in again” (FGD - women) “Fathers are mainly the decision makers in where to deliver, however some give their wives to decide where to deliver” (FGD women) 1/7/2014 16
  17. 17.   “There is inadequate staff and equipment especially Reproductive Health equipment (delivery and infant resuscitation equipment)”. (KII) “They (TBAs) are never rude and they give you the best services. They give you porridge and bathe you until you are ready to leave”. (FGD) 1/7/2014 17
  18. 18. • • • Barriers to access and utilization of maternal and infant health services in the rural areas could be attributed to socio-cultural factors such as decision making vested on the men. Inadequate staff and equipment hinders utilization and access of the services Financial barriers may be attributed to low level of education which may contribute to low income due to unemployment. 1/7/2014 18
  19. 19.  Access and utilization of maternal health services is a hindered by socio-economic, socio-cultural and health facility factors. 1/7/2014 19
  20. 20.   Addressing the several barriers hindering access and utilization of maternal and infant health services is a step towards achievement of MDGs 4 and 5. Success to improving access and utilization of maternal and infant health services requires involvement of the community and the government in policy making. 1/7/2014 20
  21. 21.      DFATD Canada for funding College of the Rockies - Moritz Schmidt and team Dedan Kimathi University of Technology Health management team– Migori County Community members of Migori County www.cotr.bc.ca/MAISHA 1/7/2014 21
  22. 22. 1/7/2014 22
  23. 23. 1/7/2014 23
  24. 24. Thank You 1/7/2014 24

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