Abstract:

The role of Traditional Birth Attendants (TBAs) in improving maternal health has been heavily debated, especially in the focus on Millennium Development Goal (MDG) 5. The use of TBAs is still high in Kenya; TBAs attend to 28% of all births, relatives attend to 21% of births, and 7% give birth without any assistance. Up to 90% of these maternal and infant deaths are caused by obstetric complications that are preventable. Understanding the factors that contributes to high utilization of TBAs among Kenyan in spite of the free maternity being offered is very important. Hence, this study aimed at determining and ascertaining the critical predisposing factors to utilization of TBAs by expectant mothers in Mombasa County, Kenya. The study adopted a survey research design and was conducted among expectant mothers using semi-structured questionnaire and interview guide. Data was collected from June to September, 2017. Multinomial logistic regression analyses were used to identify factors associated with utilization of TBAs by expectant mothers. Data was analysed using R (version 3.4.3). The study recruited 370 (96.4%) out of the expected 384 respondents. Various factors such as TBAs live among the community, poverty, culture, facilities being far, fear of harassment by nurses, number of children delivered. To improve the utilization of Skilled Birth Attendants (SBA) services, our finding suggests implementation of strategies like need to improve infrastructure and adequate maternal health services, also improving the staffing and motivation levels for health personnel

Keywords: Predisposing factors, Traditional Attendants, Skilled Attendants, Maternal Health, Mombasa County.

References:

[1].     AMREF (2015). AMREF’s Position on the Role and Services of Traditional Birth Attendants, 1–2.

[2].     Bergström S, Goodburn E. (2001). The role of traditional birth attendants in the reduction of maternal mortality. Studies in HSO&P. 17:85–89.

[3].     Bourbonnais N. (2013). Implementing Free Maternal Health Care in Kenya. Challenges, Strategies, and Recommendations. Kenya National Commission of Human Rights.

[4].     Dietsch E. (2010). The experience of being a traditional midwife: relationships with skilled birth attendants. Rural Remote Health. 10(3):1481.

[5].     Fisher AA, Laing EJ, Stoeckel EJ, Townsend WJ (1998). Handbook for family planning operations research design. 2nd. New York, NY, USA: Population Council; p.36.

[6].     Fotso, J.-C., Ezeh, A. C., & Essendi, H. (2009). Maternal health in resource-poor urban settings: how does women’s autonomy influence the utilization of obstetric care services? Reproductive Health, 6, 9.

[7].     Ikamari, L., Izugbara, C., & Ochako, R. (2013). Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya. BMC Pregnancy and Childbirth, 13(1), 69.

[8].     KDHS. (2014). Kenya demographic and health survey: Key indicators, 1–76.

[9].     Keri, L., Kaye, D., & Sibylle, K. (2010). Referral practices and perceived barriers to timely obstetric care among Ugandan traditional birth attendants (TBA). African Health Sciences, 10(1), 75–81.

[10]. KNBS, Mombasa. (2009). 2009 Census. Kenya National Bureau of Statistics.

[11]. Mannah, M. T., Warren, C., Kuria, S., & Adegoke, A. A. (2014). Opportunities and challenges in implementing community based skilled birth attendance strategy in Kenya. BMC Pregnancy and Childbirth, 14(1), 279.

[12]. Mwewa D, Michelo C (2010). Factors associated with home deliveries in a low-income rural setting-observations from Nchelenge District Zambia. Med J Zambia.37(4):234–9.

[13]. Navaneetham K, Dharmalingam A (2006). Utilization of maternal health care services in Southern India. Soc Sci Med. 55:1849–69.

[14]. Nyamtema AS, Urassa DP, Roosmalen JV (2011). Maternal health interventions in resource limited countries: a systematic review of packages, impacts and factors for change. BMC Pregnancy Childbirth. 11:30.

[15]. Omollo J. Vistoria, Oboka W. Aluoch, Janet N. Kassilly (2016). Factors influencing mothers’ choice of birth attendants in Bunyala sub- county, Kenya. International Review of Humanities and Scientific Research. 2519-5336

[16]. Shiferaw, S., Spigt, M., Godefrooij, M., Melkamu, Y., & Tekie, M. (2013). Why do women prefer home births in Ethiopia? BMC Pregnancy Childbirth, 13:2393-13-5.

[17]. Sialubanje C, Massar K, Hamer DH, Ruiter RAC (2014). Psychosocial and environmental predictors of the intention to Use maternal healthcare services in Kalomo, Zambia. Health Educ Res. 29(6):1028–40.

[18]. Stekelenburg J, Kyanamina S, Mukelabai M, Wolffers I, van Roosmalen J (2004). Waiting too long: low use of maternal health services in Kalabo, Zambia. Trop Med Int Health. 390–398.

[19]. Thaddeus S, Maine D (1994). “Too far to walk: maternal mortality in context,”. Social Science and Medicine. 38(8):1110.

[20]. Titaley CR, Hunter CL, Dibley MJ, Heywood P (2010). Why do some women still prefer traditional birth attendants and home delivery? A qualitative study on delivery care services in West Java Province, Indonesia. BMC Pregnancy Childbirth. 10:43.

[21]. Vieira, C., Portela, A., Miller, T., Coast, E., Leone, T., & Marston, C. (2012). Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: A systematic review. PLoS ONE, 7(10), e47946.

[22]. World Health Organisation (2010). Classifying Health Workers. Geneva.

[23]. World Health Organisation (1992). Traditional Birth Attendants: a joint WHO/UNFPA/UNICEF statement. Geneva.