An assessment of the knowledge, accessibility and utilization of Maternal and child health services by women of reproductive Age in Kisumu west district, Kenya

Abstract

Kenya has one of the highest maternal and child health mortality in Africa. Estimates developed by the UN inter-agency group for child mortality estimation indicate a 2011 infant mortality of 48 per 1000 live births while maternal mortality is estimated at 444 per 100,000 live births. Kisumu West District has one of the poorest maternal and child health indicators while the only measure available is the percentage of health facility based deliveries. There are no indicators for knowledge available at the health facility or the Ministry of Health departments. Despite these, the knowledge, accessibility and utilization of maternal and child health services in Kisumu West District remains unknown. Therefore, the objective of this study was to assess the knowledge, accessibility and utilization of maternal and child health services in Kisumu West District. The study used a cross-sectional survey using multistage sampling and further simple random sampling to select the study participants. Data was collected using structured questionnaires through interviews of 440 women of reproductive age. Focus group discussions were conducted for purposively selected women of reproductive age. Multivariate linear regression analysis was used to establish association of socio-demographic and socioeconomic factors with knowledge, access and utilization of maternal and child health services. Data from the FGDs were thematically summarized. Results from this study showed that the participants’ knew more than 80% of antenatal and postnatal care services offered but knowledge of neonatal and postnatal care still needs to be improved (an average of 53% of the study population identified these services). There were no national benchmarks for knowledge. The study found out that the access to maternal and child health services are higher in Kisumu West District than the national averages and this was attributed to increased outreach services and new health facilities by the government in Kisumu west District. Utilization of maternal and child health services is still lower than the WHO standards adopted by the government. Among the knowledge factors, age (P=0.021), family size (P=0.032), education (P=0.020) and income level were found to be significantly associated with knowledge. Education (P=≤0.001) and income level were found to be significantly associated with access to MCH services. Among the utilization factors, marital status (P=0.018), family size (P=0.050), occupation (P=0.006) and income level were found to be significantly associated with utilization of MCH services. The study showed that 6% of the study participants still seek services from traditional birth attendants and only 30% seek services from government health facilities because of better drugs/remedies. 65% of the study participants still have to walk more than one hour to access a health facility. The degree of utilization of maternal and child health services by women of reproductive age and their under five children in Kisumu West District, Kenya was determined to be below WHO standards which have been adopted by the Kenyan government. The socio-demographic factors associated with knowledge, accessibility and utilization of maternal and child health services were age, marital status and family size while socio-economic factors associated with knowledge, accessibility and utilization of maternal and child health services in Kisumu West District were education, occupation and income level. Continuous health information, communication and education will improve knowledge, increased outreach services is essential to increase access and utilization of maternal and child health services and improvement of the socioeconomic status of the study participants will improve knowledge, access and utilization of maternal and child health services in Kisumu West District.