DETERMINANTS OF QUALITY ANTENATAL CARE AMONG PREGNANT MOTHERS IN KISUMU COUNTY REFERRAL HOSPITAL

Abstract

Background: Maternal and neonatal mortality remains a public health burden around the globe most especially in developing countries. A well utilized quality antenatal care (ANC) is however among the identified interventions to reduce this burden of maternal and neonatal mortality rates. A lot of factors therefore predispose, enable and cause mothers to identify the need to utilize this service (ANC). These includes facility factors such as infrastructure, staffing, equipment, supplies and policy guidelines; ANC mothers' factors such as eight WHO recommended visits, cultural beliefs, knowledge and attitudes; health education factors such as significance of eight antenatal visits, nutrition, hygiene, family planning, immunizations and exercises. Aims/objectives: The aim of this study was to identify the determinants of quality antenatal care in Kisumu county referral hospital and to highlight some of the challenges that mothers and the health care providers face during the antenatal visits to reduce maternal and neonatal mortality. Methods: This study employed descriptive cross-sectional survey design. A semi-structured interview was used to assess the demographic profile of the respondents, their knowledge about ANC services, and the level of ANC utilization. Data analysis was done using the Statistical Package for Social Science software (SPSS) version 22. Results: Majority (87%) of pregnant mothers in the Kisumu County Referral Hospital attended ANC at least once during their last pregnancy of which 95% had four or more visits and 77% initiated their ANC attendance within their first trimester. It was further observed that 97% of the mothers had good knowledge about ANC. Marital status, employment status, history of obstetric complications and ANC knowledge were found to be significantly associated with ANC visits. Husbands were found to be poorly involved in ANC services in the Kisumu County, cultural aspects of Jehovah witness believers not consenting to blood transfusion procedures, understaffing, poor working environment that is congested and demoralized staffs due to delayed payments, workload also influence the quality of antenatal care in the facility. Conclusion: Marital status, employment status, history of obstetric complications and ANC knowledge predisposes most mothers to utilize ANC services. Hence, health education activities about ANC services and its importance should be channeled more to areas where ANC utilization is low, government to employ more staffs and also improve the working environment by putting up spacious room for the antenatal care services.