A model to promote utilization of skilled health providers among women of reproductive age in Kandara sub-county, Murang’a County - Kenya

Abstract

Background: Lack of utilization of skilled delivery services by pregnant women contributes to increased number of maternal and neo-natal morbidities and mortalities. In Kenya, skilled deliveries stand at 62% while unskilled deliveries stand at 38%.The maternal mortality ratio in Kenya is at 462 per thousand live births. In the study area, skilled deliveries stand at 65% while home deliveries are at 35%. The main aim of this study was to develop a model of care to improve utilization of skilled birth attendance in the study area. Methods: A qualitative research design was employed to gather information. Sample size: Women of Reproductive age n= 48, Community Health Volunteers (n=48), Community Extension Workers (n=10) and 7 health administrators. Data Management: Data was thematically arranged and analyzed using NVIVO software version 13. Results: The study identified key strategies, including client education, family and community involvement, and alignment with government policies, to enhance skilled delivery utilization. These findings contributed to strategies that yielded in development of a model of care for promoting skilled birth attendance and improving maternal-child health in the study area and beyond. Conclusion: Through a baseline study, the research team identified key client experiences and strategies, leading to the formulation of a model. Evaluation of the model, utilizing criteria from Parady et al. (2021), involved respondent ratings on a Likert scale. A mean score of 4 or higher was deemed acceptable for model adoption, while elements below 3 were eliminated and those at 3 were modified based on expert recommendations. The threshold for agreement, set at a mean score of 4, ensured reliability in consensus decision-making (Bascom et al, 2018 ). The validated model is now ready for testing and subsequent implementation. Recommendation: Government policies to adopt the model's strategies and advocates for a more extensive study, possibly an RCT or meta-analysis, for a thorough understanding. Regular evaluations and critiques of the developed model, along with exploration of diverse models in future studies, are vital for evidence-based decision-making by policymakers, ensuring ongoing improvement in care quality