Religious factors affecting utilization of maternal health Services among Nomiya church faithful in Alego-Usonga sub- County, Kenya

Abstract

Approximately 99% of all maternal deaths occur in developing countries. Previous studies have shown association between religious factors with maternal morbidity and mortality. However most of these studies have been quantitatively resulting in limited explanations on religious beliefs and practices that determine utilization of maternal health services. Whereas Kenya has reduced MMR to 362 per 100,000 live births, Siaya County still has a MMR of 691 per 100,000 live births, 4+ANC visit at 60%, skilled birth attendance at 61%, PNC at 50% and contraceptive prevalence rate at 62%, rates far below the threshold. Nomiya church has an apostolic healthcare system that promotes utilization of alternative maternal health services. Qualitative studies are yet to give explanations on how beliefs and practices affect utilization of maternal health services. Therefore, this study explored how religious factors affect utilization of maternal health services by Nomiya church faithful’s. Specifically, the study sought to find out health seeking practices, to examine how religious beliefs affect utilization of maternal health service and lastly to find how religious practices affect utilization of maternal health services by Nomiya Church faithful’s in Alego- Usonga Sub-County. Andersen behavioral Model of healthcare utilization (1995) was used to show how the population characteristics and health behavior affect utilization of maternal health services. In this qualitative descriptive study design, data was collected to saturation from 22 women of reproductive age who were Nomiya church faithful’s. Informants were purposively recruited using snowball sampling technique. Participants were interviewed using an in-depth interview guide. The data gathered were supplemented by information from focus group discussion with 6 community health volunteers and 7 key informants including a bishop of Nomiya church and 6 health care workers who were purposively selected and interviewed. Interviews were audio recorded. Data were transcribed, translated from ‘Dholuo’ into English and reviewed by a qualitative research expert. Data were analyzed thematically. Deductive coding and categorizing of themes was done. Transcripts were uploaded and analysis done using NVIVO Version 6. Findings show that women delay to start ante-natal clinic because of fear of long waiting time for test results and many re-visits demanded. Instead, they were attended to by ‘madha’ (church ordained female birth attendant) who have skilled hands in massaging pregnant mothers and conducting deliveries. Mothers in-law prefer women to deliver at home, avoid family planning services with the church teachings asserting that FP initiatives lead to infertility and disgrace women. The Apostolic health system prescribed seclusion that demands the keeping of the mother and the child indoors for 33 to 66 days, with tough preaching against contraceptive use at the end of seclusion. There is need for reorientation of skilled health providers in the delivery of maternal health services, sensitization on skilled healthcare services in the community and to find contextual meaning of the religious practices to eliminate the retrogressive practices