A system approach to improving maternal and child health care delivery in Kenyan communities and primary care facilities: baseline survey on maternal health.

backgroundMaternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities.

objectivesThe study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya.

methodsThis was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016.

resultsA total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility.

conclusionFindings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester.