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Barriers affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Background: Antenatal care (ANC), facility delivery and postnatal care (PNC), are proven to reduce maternal and child mortality and morbidity in high burden settings. However, few rural pregnant women use these services sufficiently and it is essential to identify the barriers.

Aim: The aim of this study was to examine barriers, with a focus on water, sanitation and hygiene (WASH), affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya, and to examine if the Afya intervention helped overcome barriers.

Methods: A qualitative study was conducted in the Siaya County, Kenya. 25 mothers were selected by using purposive sampling for in-depth interviews and focus group discussions. Assessment of WASH facilities was conducted at 5 healthcare facilities. Data were analysed by content analysis method. The “three delay model” informed the analytic process and discussion.

Results: Women delayed seeking or did not attend ANC and PNC or gave birth at home, due to lack of knowledge of benefits of maternal health services and on complications; traditional and religious beliefs; embarrassed over pregnancy; busy with other life activities or of fear of HIV status and hospitals. Gender norms, distance and transport costs were the contributing factor for delaying in reaching the hospital. Unprofessional and inadequate number of staff, lack of equipment and supplies, and the water, sanitation and hygiene quality were factors delaying receiving quality care. The assessment showed on inadequate WASH facilities.

Conclusion: Use of antenatal care, delivery and postnatal care in rural western Kenya is influenced by several barriers. The findings suggest a need to increase the knowledge about ANC and PNC, and to lower barriers preventing women from reaching the healthcare facility. There is also a need to improve the WASH facilities and the healthcare personnel’s treatment.

Place, publisher, year, edition, pages
2019.
Keywords [en]
Barriers, Water, sanitation & hygiene (WASH), Health seeking behaviour, Antenatal care, Postnatal care.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-387655OAI: oai:DiVA.org:uu-387655DiVA, id: diva2:1329910
External cooperation
Stockholm Environment Institute (SEI); Safe Water and AIDS Project (SWAP)
Subject / course
Public Health
Educational program
Master Programme in Public Health
Supervisors
Examiners
Available from: 2019-06-26 Created: 2019-06-25 Last updated: 2019-06-26Bibliographically approved

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Public Health, Global Health, Social Medicine and Epidemiology

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CiteExportLink to record
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Citation style
  • apa
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Language
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  • Other locale
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