Factors affecting utilization of skilled delivery services in public health facilities by women of Somali origin in Kamukunji sub-county, Nairobi county, Kenya

Abstract

In Kenya, 21% of deaths to women of reproductive age were due to pregnancy related causes in 2014. Nairobi County is ranked 3rd amongst the leading 15 Counties in Kenya in maternal deaths. Kamukunji sub County, with a high proportion of people of Somali origin, is one of the sub-counties with comparably high maternal death rates in Nairobi County. Kenya is promoting skilled care during pregnancy and childbirth for both mothers and new-borns in line with the WHO recommendations. However, only about 21.7% of urban women refugees including women of Somali origin use skilled delivery services in public health facilities in Nairobi, in contrast to high proportion (82 %) of Kenyan women living in urban areas. In Kamukunji Sub-County, reports indicate that use of hospital deliveries services by women of Somali origin, the leading ethnic community and comprising 30% of the total women of reproductive age, is low. The true prevalence of use of hospital delivery services and factors affecting utilization of health services for health deliveries by the women of Somali origin in Kamukunji, however, are unknown. Delineating these facts would be significant to public health policy makers, planners and practitioners in identifying special focus areas that need to be addressed in efforts geared towards improvement the maternal health of this subpopulation. The main objective of this study is to assess factors affecting utilization of hospital delivery services by women of Somali origin in Kamukunji sub-County. The specific objectives are to: determine the socio-demographic factors; establish the economic factors; determine cultural factors and determine the perceptions of Community Health Workers on factors affecting utilization of skilled delivery services by women of Somali origin in Kamukunji sub-County. The study will be cross-sectional in design with sampling of participants calculated using Fisher Formula. A total of 302 participants will be interviewed. The instruments for data collection will be structured questionnaire and key interview guide using interview guides. Qualitative data will be coded while descriptive statistics will be used to calculate proportions. Categorical data will be analysed using chi-square. Binary multiple logistic regression analysis will be performed to identify factors affecting the use of delivery services.