The effect of lack of female autonomy on utilization of health facilities for birth delivery care in Nyanza Province of Kenya

Avec le soutien financier de/ supported by : Ministère français des Affaires étrangères, Commission Européenne/ European Commission, Danida, Sarec, Agence Universitaire de la Francophonie et Agence intergouvernementale de la Francophonie, Institut national d'Etudes Démographiques (INED), Fonds des Nations Unies pour la Population (FNUAP) 2 Abstract. Maternal mortality rate in Kenya is high varying between 100 to 500 per 100,000 live births. Several factors contribute to this high rates including inadequate health facilities, poor quality of prenatal and delivery care, high incidences of unwanted pregnancies leading to illicit abortions, high incidences of infections during pregnancy, and under utilization of available medical facilities. Only 38 per cent of pregnant women in Nyanza province deliver in a health facility. This makes childbearing very risky and dangerous since place of delivery and the personnel assisting can greatly determine the risk of complications and infections that a mother is exposed to. The risk of complications and death has been found to increase when a significant proportion of mothers fail to utilise available health facilities for delivery care and post partum care. A community study was conducted in 1998 to find out causes of under-utilisation of health facilities for delivery care i n this region that is also characterised by the highest maternal mortality and infant mortality rates in Kenya. A sample of 200 women who delivered at home and 200 who delivered in a health facility were interviewed in the survey. Descriptive statistics are used to show the percent distribution of these respondents along socioeconomic characteristics. Multivariate analysis is conducted to identify the key determinants of under-utilization of health care facilities for delivery care in the study are. The main findings indicate that there exists some socioeconomic and cultural factors that influence decision to seek care. These factors revolve around lack of female autonomy. This paper discusses these issues and suggests policy implications. 3 Introduction. In rural Kenya, 60% of pregnant women deliver at home whereas only 40% Utilize the available health facilities. Place of delivery is very important because the medical attention and hygienic conditions that are available in a health facility can reduce risk of complications and infections which may be fatal to both mother and child. Complications related to pregnancy and child birth are among the leading causes of mortality among women of reproductive age in Kenya. The risk of complications and death increases when a significant proportion of mothers fail to …