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Barriers and facilitators to antenatal and delivery care in western Kenya: a qualitative study

Show simple item record Linda Mason, Stephanie Dellicour, Feiko Ter Kuile, Peter Ouma, Penny Phillips-Howard, Florence Were, Kayla Laserson, Meghna Desai 2021-01-08T07:33:37Z 2021-01-08T07:33:37Z 2015
dc.description.abstract Background In western Kenya, maternal mortality is a major public health problem estimated at 730/100,000 live births, higher than the Kenyan national average of 488/100,000 women. Many women do not attend antenatal care (ANC) in the first trimester, half do not receive 4 ANC visits. A high proportion use traditional birth attendants (TBA) for delivery and 1 in five deliver unassisted. The present study was carried out to ascertain why women do not fully utilise health facility ANC and delivery services. Methods A qualitative study using 8 focus group discussions each consisting of 8–10 women, aged 15–49 years. Thematic analysis identified the main barriers and facilitators to health facility based ANC and delivery. Results Attending health facility for ANC was viewed positively. Three elements of care were important; testing for disease including HIV, checking the position of the foetus, and receiving injections and / or medications. Receiving a bed net and obtaining a registration card were also valuable. Four barriers to attending a health facility for ANC were evident; attitudes of clinic staff, long clinic waiting times, HIV testing and cost, although not all women felt the cost was prohibitive being worth it for the health of the child. Most women preferred to deliver in a health facility due to better management of complications. However cost was a barrier, and a reason to visit a TBA because of flexible payment. Other barriers were unpredictable labour and transport, staff attitudes and husbands’ preference. Conclusions Our findings suggest that women in western Kenya are amenable to ANC and would be willing and even prefer to deliver in a healthcare facility, if it were affordable and accessible to them. However for this to happen there needs to be investment in health promotion, and transport, as well as reducing or removing all fees associated with antenatal and delivery care. Yet creating demand for service will need to go alongside investment in antenatal services at organisational, staffing and facility level in order to meet both current and future increase in demand en_US
dc.publisher BioMed Central en_US
dc.subject Qualitative, Antenatal care, Delivery care, Barriers, Facilitators, Western Kenya en_US
dc.title Barriers and facilitators to antenatal and delivery care in western Kenya: a qualitative study en_US
dc.type Article en_US

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