Socio-demographic factors influencing the use of free maternal health services among pregnant women

Authors

  • Godfrey Kipsang Ronoh Department of Community Health, Biostatistics and Epidemiology, School of Public Health, Mount Kenya University, Thika, Kenya
  • Joseph Muchiri Department of Community Health, Biostatistics and Epidemiology, School of Public Health, Mount Kenya University, Thika, Kenya
  • Mbaruk Suleiman Department of Community Health, Biostatistics and Epidemiology, School of Public Health, Mount Kenya University, Thika, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20251358

Keywords:

Free maternal health services, Maternal health, Maternal mortality

Abstract

Background: Maternal health remains a major public health challenge, particularly in low- and middle-income countries. Despite Kenya’s efforts to provide free maternal healthcare, maternal mortality rates remain high in Turkana Central Sub-County due to socio-cultural, economic, and infrastructural barriers.

Methods: A cross-sectional study was conducted in Turkana Central Sub-County to assess factors influencing the uptake of free maternal health services. Data were collected using structured questionnaires and focus group discussions. Quantitative data were analyzed using SPSS version 29, employing chi-square tests and logistic regression to examine associations between socio-demographic factors and service utilization. A significance level of p<0.05 was applied.

Results: The study included 210 participants, most aged 20-24 (16.2%) and married (49.0%). The majority were Christians (82.5%) and self-employed (63.3%), with 79.5% having no or only primary education. Age (p=0.012), parity (p=0.011), and household income (p=0.013) were significantly associated with service utilization, while marital status, religion, income source, and education level were not. Women aged 25-29 were less likely to utilize free maternal health services (OR=0.141, p=0.007), whereas lower-income women (Ksh. 0-2,500) were more likely (OR=2.584, p = 0.036). Higher income levels correlated with decreased uptake.

Conclusions: Age, parity, and household income significantly influenced the utilization of free maternal health services. Financial constraints remain a key determinant, with lower-income women more reliant on free services. Efforts to improve maternal health should prioritize increasing awareness and accessibility.

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References

Dahab R, Sakellariou D. Barriers to accessing maternal care in low income countries in Africa: a systematic review. Int J Environ Res Public Health. 2020;17(12):4292.

United Nations. Goal 3 Department of Economic and Social Affairs, 2023. Available at: https://sdgs.un.org/goals/goal3. Accessed 15 February 2025.

Shikuku DN, Nyaoke I, Maina O, Eyinda M, Gichuru S, Nyaga L, et al. The determinants of staff retention after Emergency Obstetrics and Newborn Care training in Kenya: a cross-sectional study. BMC Health Serv Res. 2022;22(1):872. DOI: https://doi.org/10.1186/s12913-022-08253-2

Awe OD, Kipruto H, Awe O, Chukwudum QC. Trend analysis of maternal mortality in Kenya: post-devolution empirical results. East Afr Health Res J. 2023;7(2):166-174. DOI: https://doi.org/10.24248/eahrj.v7i2.728

Etee PE. Predictors of utilization of skilled birth attendants among women of reproductive age in Turkana central sub-county, Turkana County, Kenya, 2017. Available at: http://ir-library.ku.ac.ke/handle/123456789/18433. Accessed 15 February 2025.

Asibitar R. Maternal and newborn health rights project in the pipeline for turkana - Turkana County Government, 2024. Available at: https://turkana.go.ke/2024/12/13/maternal-and-newborn-health-rights-project-in-the-pipeline-for-turkana/. Accessed 15 February 2025.

Nambile Cumber S, Atuhaire C, Namuli V, Bogren M, Elden H. Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study. Glob Health Action. 2022;15(1):2067397. DOI: https://doi.org/10.1080/16549716.2022.2067397

Nuamah GB, Agyei-Baffour P, Mensah KA, Boateng D, Quansah DY, Dobin D, et al. Access and utilization of maternal healthcare in a rural district in the forest belt of Ghana. BMC Pregn Childb. 2019;19(1):6. DOI: https://doi.org/10.1186/s12884-018-2159-5

Samba M, Attia-Konan AR, Sangaré AD, Youan GJ, Kouadio LP, Bakayoko-Ly R. Factors associated with the use of maternal health services by mothers in a post-conflict area of western Côte d’Ivoire in 2016. BMC Health Serv Res. 2020;20:136. DOI: https://doi.org/10.1186/s12913-020-4976-2

Mochache V, Wanje G, Nyagah L, Lakhani A, El-Busaidy H, Temmerman M, et al. Religious, socio-cultural norms and gender stereotypes influence uptake and utilization of maternal health services among the Digo community in Kwale, Kenya: a qualitative study. Reprod Health. 2020;17:71. DOI: https://doi.org/10.1186/s12978-020-00919-6

Opara UC, Iheanacho PN, Petrucka P. Cultural and religious structures influencing the use of maternal health services in Nigeria: a focused ethnographic research. Reproductive Health. 2024;21(1):188. DOI: https://doi.org/10.1186/s12978-024-01933-8

Souza JP, Day LT, Rezende-Gomes AC, Zhang J, Mori R, Baguiya A, et al. A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health. 2024;12(2):e306-e316. DOI: https://doi.org/10.1016/S2214-109X(23)00468-0

Dior UP, Hochner H, Friedlander Y, Calderon-Margalit R, Jaffe D, Burger A, et al. Association between number of children and mortality of mothers: results of a 37-year follow-up study. Ann Epidemiol. 2013;23(1):13-8. DOI: https://doi.org/10.1016/j.annepidem.2012.10.005

Ahinkorah BO, Seidu AA, Agbaglo E, Adu C, Budu E, Hagan JE, et al. Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data. BMC Pregn Childb. 2021;21:2. DOI: https://doi.org/10.1186/s12884-020-03489-4

Esther AQ, Yahaya H, Esther AO, Aboagye-Mensah P, Blessing AJ, Ikome TE. A scoping review on influence of socioeconomic status on antenatal care utilization and pregnancy outcomes in sub-Saharan Africa. MedRxiv. 2024:2024-01. DOI: https://doi.org/10.1101/2024.01.11.24301063

Gao M, Fang Y, Liu Z, Xu X, You H, Wu Q. Factors associated with maternal healthcare utilization before and after delivery among migrant pregnant women in china: an observational study. Risk Manag Healthc Policy. 2023;16:1653-65. DOI: https://doi.org/10.2147/RMHP.S423723

Wang H, Frasco E, Takesue R, Tang K. Maternal education level and maternal healthcare utilization in the Democratic Republic of the Congo: an analysis of the multiple indicator cluster survey 2017/18. BMC Health Serv Res. 2021;21(1):850. DOI: https://doi.org/10.1186/s12913-021-06854-x

Barman B, Saha J, Chouhan P. Impact of education on the utilization of maternal health care services: An investigation from National Family Health Survey (2015–16) in India. Children and Youth Services Review. 2020;108:104642. DOI: https://doi.org/10.1016/j.childyouth.2019.104642

Dahab R, Sakellariou D. Barriers to accessing maternal care in low income countries in Africa: a systematic review. Int J Environ Res Public Health. 2020;17(12):4292. DOI: https://doi.org/10.3390/ijerph17124292

Dhillon RS, Bonds MH, Fraden M, Ndahiro D, Ruxin J. The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda. Glob Public Health. 2012;7(1):71-86. DOI: https://doi.org/10.1080/17441692.2011.593536

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Published

2025-04-30

How to Cite

Ronoh, G. K., Muchiri, J., & Suleiman, M. (2025). Socio-demographic factors influencing the use of free maternal health services among pregnant women. International Journal Of Community Medicine And Public Health, 12(5), 2059–2065. https://doi.org/10.18203/2394-6040.ijcmph20251358

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Original Research Articles