DETERMINANTS OF MATERNAL HEALTH CARE SERVICE UTILIZATION IN GANZE DISTRICT, KILIFI COUNTY OF KENYA
WECHULI , STANLEY WANJALA
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Maternal health care service utilization is an important health issue related to both maternal and child survival as it reduces maternal mortality and morbidity as well as improving the well being of mothers and their children before, during and after birth. Considering low utilization of maternal health care service especially in Sub-Saharan Africa, understanding what determines utilization becomes important. This study set out to examine determinants of maternal health care service utilization by women of reproductive ages (18-49 years) with a view to enhancing the achievement of Millennium Development Goal (MDG) number five (5). Four dependent variables: place of delivery, antenatal care, skilled attendance at birth and trimester women attended Antenatal Clinic (ANC) as well as six independent variables representing predisposing characteristics (mothers age at birth, marital status, religion, educational attainment, parity) and enabling factors (husbands educational attainment, income levels) were selected. Survey research design was used in data collection and the main data collection tool was an interview schedule. Multi-stage cluster sampling was used in sampling the health care facilities and convenient sampling was used to sample the respondents. Both descriptive and inferential statistics such as logistic regression analysis were applied to the analysis of the collected data. The key findings of the study show that religion, parity and maternal education were significant predictors of women’s place of delivery. Further, maternal age, marital status, and parity were found to be significantly associated with the number of ANC visits women make to the clinic. Marital status, religion and parity are all related to use of a skilled Birth Attendant at birth. Parity emerged to be the strongest predictor among all the other indicators of maternal health care service utilization considered in the study. In conclusion, the study was able to find out factors that affect utilization of maternal health care services in Ganze district thus achieving the study objective. Strategies to promote the utilization of Maternal Health Care Services should thus focus on the relevant predictors established in the models based on the binomial regression analyses. The findings of the study may help the Ministry of Health, policy makers and health related agencies and stakeholders to design appropriate and cost-effective intervention programmes targeting areas with most needs. This may lead to prudent use of resources in the management of maternal health and hence mitigating maternal mortality while enhancing reproductive health and resource efficiency. Lastly, this study aims at stimulating further research in this area, thus bridging knowledge gaps and updating scientific knowledge on this important topic.