"If there are no female nurses to attend to me, I will just go and deliver at home": a qualitative study in Garissa, Kenya
- PMID: 31500582
- PMCID: PMC6734258
- DOI: 10.1186/s12884-019-2477-2
"If there are no female nurses to attend to me, I will just go and deliver at home": a qualitative study in Garissa, Kenya
Abstract
Background: The North Eastern region in Kenya experiences challenges in the utilization of maternal and newborn health services. In this region, culture and religion play a major role in influencing healthcare seeking behaviour of the community. This study was conducted to (i) understand key inherent barriers to health facility delivery in the Somali community of North Eastern Kenya and (ii) inform interventions on specific needs of this community.
Methods: The study was conducted among community members of Garissa sub-County as part of a baseline assessment before the implementation of an intervention package aimed at creating demand and increasing utilization of maternal and newborn services. Focus group discussions and key informant interviews were conducted with clan leaders, Imams, health managers, member of the county assembly, and service users (women and men) in three locations of Garissa sub-County. Data were analysed through content analysis, by coding recurrent themes and pre-established themes.
Results: Using health facility for delivery was widely acceptable and most respondents acknowledged the advantages and benefits of skilled birth delivery. However, a commonly cited barrier in using health facility delivery was the issue of male nurses and doctors attending to women in labour. According to participants, it is against their culture and thus a key disincentive to using maternity services. Living far from the health facility and lack of a proper and reliable means of transportation was also highlighted as a reason for home delivery. At the health facility level, respondents complained about the poor attitude of health care providers, especially female nurses being disrespectful; and the limited availability of healthcare workers, equipment and supplies. Lack of awareness and information on the importance of skilled birth attendance was also noted.
Conclusion: To increase health facility delivery, interventions need to offer services that take into consideration the sociocultural aspect of the recipients. Culturally acceptable and sensitive services, and awareness on the benefits of skilled birth attendance among the community members are likely to attract more women to use maternity services and thus reduce adverse maternal and newborn health outcomes.
Keywords: Barriers; Kenya; Skilled birth attendance; Sociocultural factors health facility delivery.
Conflict of interest statement
The authors declare that they have no competing interests.
References
-
- United Nations. The Millennium Development Goals Report 2015 [Internet]. New York: United Nations; 2015. Available from: http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG 2015 rev (July 1).pdf
-
- You D, Hug L, Ejdemyr S, Beise J. Levels and trends in child mortality. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation (IGME). Report 2015. 2015.
-
- United Nations. Sustainable development goals report 2017 [internet]. New York: United Nations publications- department of economic and social affairs (DESA); 2017. Available from: https://unstats.un.org/sdgs/files/report/2017/thesustainabledevelopmentg...
-
- Kenya National Bureau of Statistics, Ministry of Health, National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development TDPII. Kenya Demographic and Health Survey 2014 [Internet]. Rockville; 2015. Available from: http://dhsprogram.com/pubs/pdf/FR308/FR308.pdf.
-
- National Council for Population and Development. Reducing Maternal Deaths in Kenya- Policy Brief. Nairobi: Communications department, UNFPA Kenya; 2015.
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical