ASSESSMENT OF COMMUNITY BASED APPROACHES TOWARDS UTILIZATION OF SKILLED BIRTH DELIVERY AMONG EXPECTANT MOTHERS IN MWANAMWINGA WARD, KILIFI COUNTY IN KENYA

Abstract

A community-based approach is a valuable programme in the provision of skilled birth delivery, especially in resource poor communities. Nevertheless, its application in ensuring utilization of skilled birth deliveries has not been clearly documented. A number of strategies have been proposed to reduce the cases of maternal death rates; one of them being the use of skilled delivery through the community-based approaches. It is against such alignments and propositions that this study was carried out, aiming at assessing community-based approaches towards utilization of skilled birth delivery among expectant mothers in Mwanamwinga Ward in Kilifi County, Kenya. The study was guided by a broad objective which aimed at assessing community-based approaches towards utilization of skilled birth deliveries among expectant mothers in Mwanamwinga Ward, in Kilifi County, Kenya. Additionally, the study emphasized on specific objectives which were to identify community-based approaches used to enhance skilled birth deliveries among expectant mothers in Mwanamwinga Ward, to find out the influence of community health volunteers in promoting utilization of skilled deliveries through community-based approaches in Mwanamwinga ward and lastly to establish the factors hindering utilization of skilled birth deliveries among expectant mothers in Mwanamwinga ward. A descriptive cross-sectional survey study design was adopted and random sampling technique used to recruit respondents from the study population. Focused group discussions were used to obtain data from women of reproductive age (18-49 years) who had delivered at the health facilities eleven months prior to the study. Data collection involved community health volunteers from the study areas with key informant interviews used to collect data from the community health extension workers. Descriptive analysis was done and Chi-square used to test the association between the independent and dependent variables. In assessment of the community-based approaches that enhance access to skilled delivery services, the study concluded that community-based approaches impact positively on demand for health services with the following scores, household visits (SD=1.337), advocacy (SD=1.303) and Community dialogues (SD= 0.724).In relation to Barriers hindering utilization of skilled delivery the study vi found socio-demographic variables, (SD=1.113), accessibility factors (SD=1.069) and perceived benefit factors (SD=0.527) to have been among the barriers. When all the factors were measured by Pillai's Trace, Wilks' Lambda, Hotelling's Trace, and Roy's Largest Root had a Significance value of 0.001 meaning that all the interacting factors have a positive and significant hindrance to community-based approaches towards utilization of skilled birth deliveries among expectant mothers. The insights from the study findings reveal and conclude that CHVs influenced hospital delivery through health education, and referrals of antenatal mothers. The sets of recommendations proposed in the study include formulation of community health policies that will improve service delivery, especially on skilled deliveries, through policy direction that spur effective health care delivery strategies, for utilizing community-based approaches. Need to solidify and anchor community-based approaches in the rural areas through the support of CHVs, inter-sectoral partnerships and collaborations with the private sector in delivering maternal services to the hard-to-reach populations.