TY - JOUR
T1 - A qualitative exploration of barriers to health-facility-based delivery in Bomachoge-Borabu and Kaloleni, Kenya
AU - Naanyu, Violet
AU - Wade, Terrance J.
AU - Ngetich, Angela
AU - Mulama, Kennedy
AU - Nyaga, Lucy
AU - Pell, Rachel
AU - Mossman, Lindsay
AU - Obure, Jerim
AU - Temmerman, Marleen
N1 - Funding Information:
AQCESS is a Maternal, Newborn and Child Health (MNCH) project supported by the Aga Khan Foundation Canada. It is implemented in Kenya, Mali, Mozambique, and Pakistan in partnership with local agencies of the Aga Khan Development Network and in collaboration with local authorities. AQCESS aims to improve the availability, quality, and utilization of essential health services for pregnant women, newborns, and children under 5 years of age across select geographies in four countries. Encouragement of health‐facility delivery is one of the key health indicators that the project hopes to improve on, as a way of improving maternal and child health outcomes.
Funding Information:
The authors wish to thank the County governments of Kilifi and Kisii for approvals and facilitation of AQCESS programming and associated research activities. We are grateful to the Monitoring, Evaluation, Research & Learning Unit, Centre of Excellence in Women and Child Health, Aga Khan University & The Hospital for Sick Children’s Centre for Global Child Health, Toronto, the Aga Khan Foundation East Africa and Canada, and the Government of Canada for supporting this work. Special thanks go to the AQCESS Teams on the ground for facilitating community entry and identification of potential research assistants. We would also like to thank the Bomachoge‐Borabu and Kaloleni community members for their warm reception. The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the funding agencies.
Publisher Copyright:
© 2020 International Federation of Gynecology and Obstetrics
PY - 2021/5
Y1 - 2021/5
N2 - Objective: To explore barriers to utilization of health-facility-based delivery in Kenya, use of which is associated with reduced maternal mortality. Methods: In April 2017, a qualitative study utilizing key informant interviews (KIIs) and focus group discussions (FGDs) was carried out in Bomachoge-Borabu and Kaloleni, Kenya. Twenty-four KIIs were performed including health service providers, community health workers, religious leaders, local government representatives, Ministry of Health representatives, and representatives of women's organizations. Sixteen FGDs were held separately with adolescent females, adult females, adult males, and Community Health Committee members. Data were transcribed, coded, and categorized thematically to illustrate supply-side and demand-side barriers to use of health-facility-based delivery services. Results: Supply-side barriers included staff shortages, inadequate supplies and space, poor interpersonal relations, few trained staff, long distance to services, poor transport infrastructure, and limited service hours. Demand-side barriers included financial constraints, limited spousal support, observance of birthing traditions, limited knowledge on importance of health-facility-based delivery, and fear of health-facility procedures. Conclusions: Diverse barriers continue to influence use of health-facility-based delivery services in Kenya. Practical, integrated interventions are urgently needed to reduce barriers noted, to further reduce the maternal mortality rate.
AB - Objective: To explore barriers to utilization of health-facility-based delivery in Kenya, use of which is associated with reduced maternal mortality. Methods: In April 2017, a qualitative study utilizing key informant interviews (KIIs) and focus group discussions (FGDs) was carried out in Bomachoge-Borabu and Kaloleni, Kenya. Twenty-four KIIs were performed including health service providers, community health workers, religious leaders, local government representatives, Ministry of Health representatives, and representatives of women's organizations. Sixteen FGDs were held separately with adolescent females, adult females, adult males, and Community Health Committee members. Data were transcribed, coded, and categorized thematically to illustrate supply-side and demand-side barriers to use of health-facility-based delivery services. Results: Supply-side barriers included staff shortages, inadequate supplies and space, poor interpersonal relations, few trained staff, long distance to services, poor transport infrastructure, and limited service hours. Demand-side barriers included financial constraints, limited spousal support, observance of birthing traditions, limited knowledge on importance of health-facility-based delivery, and fear of health-facility procedures. Conclusions: Diverse barriers continue to influence use of health-facility-based delivery services in Kenya. Practical, integrated interventions are urgently needed to reduce barriers noted, to further reduce the maternal mortality rate.
KW - Access to care
KW - Barriers to care
KW - Childbirth
KW - Facility-based delivery
KW - Kenya
KW - Maternal health
UR - http://www.scopus.com/inward/record.url?scp=85097819139&partnerID=8YFLogxK
U2 - 10.1002/ijgo.13450
DO - 10.1002/ijgo.13450
M3 - Article
C2 - 33119127
AN - SCOPUS:85097819139
SN - 0020-7292
VL - 153
SP - 273
EP - 279
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 2
ER -
