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A qualitative exploration of barriers to health facility‐based delivery in Bomachoge Borabu and Kaloleni, Kenya

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Abstract
Objective: To explore barriers to utilization of health-facility-based delivery in Kenya, use of which is associated with reduced maternal mortality. Methods: In April 2017, a qualitative study utilizing key informant interviews (KIIs) and focus group discussions (FGDs) was carried out in Bomachoge-Borabu and Kaloleni, Kenya. Twenty-four KIIs were performed including health service providers, community health workers, religious leaders, local government representatives, Ministry of Health representatives, and representatives of women's organizations. Sixteen FGDs were held separately with adolescent females, adult females, adult males, and Community Health Committee members. Data were transcribed, coded, and categorized thematically to illustrate supply-side and demand-side barriers to use of health-facility-based delivery services. Results: Supply-side barriers included staff shortages, inadequate supplies and space, poor interpersonal relations, few trained staff, long distance to services, poor transport infrastructure, and limited service hours. Demand-side barriers included financial constraints, limited spousal support, observance of birthing traditions, limited knowledge on importance of health-facility-based delivery, and fear of health-facility procedures. Conclusions: Diverse barriers continue to influence use of health-facility-based delivery services in Kenya. Practical, integrated interventions are urgently needed to reduce barriers noted, to further reduce the maternal mortality rate.
Keywords
Access to care, Barriers to care, Childbirth, Facility-based delivery, Kenya, Maternal health

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MLA
Naanyu, Violet, et al. “A Qualitative Exploration of Barriers to Health Facility‐based Delivery in Bomachoge Borabu and Kaloleni, Kenya.” INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, vol. 153, no. 2, 2021, pp. 273–79, doi:10.1002/ijgo.13450.
APA
Naanyu, V., Wade, T. J., Ngetich, A., Mulama, K., Nyaga, L., Pell, R., … Temmerman, M. (2021). A qualitative exploration of barriers to health facility‐based delivery in Bomachoge Borabu and Kaloleni, Kenya. INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 153(2), 273–279. https://doi.org/10.1002/ijgo.13450
Chicago author-date
Naanyu, Violet, Terrance J. Wade, Angela Ngetich, Kennedy Mulama, Lucy Nyaga, Rachel Pell, Lindsay Mossman, Jerim Obure, and Marleen Temmerman. 2021. “A Qualitative Exploration of Barriers to Health Facility‐based Delivery in Bomachoge Borabu and Kaloleni, Kenya.” INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 153 (2): 273–79. https://doi.org/10.1002/ijgo.13450.
Chicago author-date (all authors)
Naanyu, Violet, Terrance J. Wade, Angela Ngetich, Kennedy Mulama, Lucy Nyaga, Rachel Pell, Lindsay Mossman, Jerim Obure, and Marleen Temmerman. 2021. “A Qualitative Exploration of Barriers to Health Facility‐based Delivery in Bomachoge Borabu and Kaloleni, Kenya.” INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 153 (2): 273–279. doi:10.1002/ijgo.13450.
Vancouver
1.
Naanyu V, Wade TJ, Ngetich A, Mulama K, Nyaga L, Pell R, et al. A qualitative exploration of barriers to health facility‐based delivery in Bomachoge Borabu and Kaloleni, Kenya. INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS. 2021;153(2):273–9.
IEEE
[1]
V. Naanyu et al., “A qualitative exploration of barriers to health facility‐based delivery in Bomachoge Borabu and Kaloleni, Kenya,” INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, vol. 153, no. 2, pp. 273–279, 2021.
@article{8685310,
  abstract     = {{Objective: To explore barriers to utilization of health-facility-based delivery in Kenya, use of which is associated with reduced maternal mortality.

Methods: In April 2017, a qualitative study utilizing key informant interviews (KIIs) and focus group discussions (FGDs) was carried out in Bomachoge-Borabu and Kaloleni, Kenya. Twenty-four KIIs were performed including health service providers, community health workers, religious leaders, local government representatives, Ministry of Health representatives, and representatives of women's organizations. Sixteen FGDs were held separately with adolescent females, adult females, adult males, and Community Health Committee members. Data were transcribed, coded, and categorized thematically to illustrate supply-side and demand-side barriers to use of health-facility-based delivery services.

Results: Supply-side barriers included staff shortages, inadequate supplies and space, poor interpersonal relations, few trained staff, long distance to services, poor transport infrastructure, and limited service hours. Demand-side barriers included financial constraints, limited spousal support, observance of birthing traditions, limited knowledge on importance of health-facility-based delivery, and fear of health-facility procedures.

Conclusions: Diverse barriers continue to influence use of health-facility-based delivery services in Kenya. Practical, integrated interventions are urgently needed to reduce barriers noted, to further reduce the maternal mortality rate.}},
  author       = {{Naanyu, Violet and Wade, Terrance J. and Ngetich, Angela and Mulama, Kennedy and Nyaga, Lucy and Pell, Rachel and Mossman, Lindsay and Obure, Jerim and Temmerman, Marleen}},
  issn         = {{0020-7292}},
  journal      = {{INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS}},
  keywords     = {{Access to care,Barriers to care,Childbirth,Facility-based delivery,Kenya,Maternal health}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{273--279}},
  title        = {{A qualitative exploration of barriers to health facility‐based delivery in Bomachoge Borabu and Kaloleni, Kenya}},
  url          = {{http://dx.doi.org/10.1002/ijgo.13450}},
  volume       = {{153}},
  year         = {{2021}},
}

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