Negotiating Access to Maternal Health Services During COVID-19 Pandemic in Kilifi County, Kenya: Rapid Qualitative Study

Abstract

Globally, women do a lot of unpaid work even before the onset of the COVID-19 pandemic. COVID-19 has delivered a blow to existing gender systems that could recalibrate gender roles, positively affecting population health. Initial research suggests that the crisis and its consequent shutdown responses have resulted in an intense increase in this burden. There is a dearth of information on expectant mothers’ negotiation mechanisms to access maternal health services during COVID-19 in Kenya. This rapid qualitative study draws data from purposefully selected 12 mothers who were either pregnant or had newborn babies during the COVID-19 pandemic in Kilifi county. Data were analyzed thematically and presented in a textual description, with at least five ideal typologies of emic alternatives to negotiating access to maternal health care. This chapter describes experiences of of women with their husbands’ presence or absence and how this impacted access to maternal health services. In this study, the household economic situation, in particular, emerged as a crucial gendered factor associated with negotiation for access to maternal health care. For the migrant husbands, most women used a range of other options to ensure that they fed or get money to sustain their families. Therefore, most households had minimax strategies to buffer risk in accessing maternal health services during COVID-19. The findings show that gender norms sustain a hierarchy of power that reinforces a systemic inequality that undermines women’s rights and restricts them from accessing maternal health services during pandemics.