Barriers to Utilization of Skilled Birth Attendance Among Post-Natal Women in North Horr Ward, Marsarbit County

Abstract

Background: Despite governmental efforts to expand access, reliance on unskilled birth attendants (UBAs) persists in the remote parts of North Horr Ward. Objectives: To examine barriers to utilization of skilled birth attendance (SBA) among women in North Horr ward, Marsabit County. Specific aims were assessing potential demographic, economic, sociocultural, and health facility barriers that facilitate home deliveries. Methods: A cross-sectional research design with a mixed methods approach. A study population entailed postnatal women aged 15 to 49 years living in North Horr. The ward population is 17,217 and the women of reproductive age 29 % (KNBS, 2019). A survey questionnaire captured quantitative data from 306 women, while 15 semi-structured interviews were conducted to support the quantitative findings. Quantitative data were analyzed through descriptive and inferential statistics using Stata version 15, while qualitative data were analyzed thematically using NVIVO and presented in tabular form. Results: A total of 306 women participated (mean age=33 years). age group(p=.0001) , Costs of transport and poor infrastructures((p=.0001) and All health facility factors were significantly associated with the place of last delivery (p=.001) .92% (n=281) were married, 97% (n=297) had children, and unemployment 98% (n=300). 50% (n=153) delivered at health facilities, 47% (n=144) at home. Qualitative findings revealed financial constraints, sociocultural norms, and health infrastructure deficits. Conclusions and Recommendations: Multiple barriers negatively affect the utilization of SBA among women in North Horr. Younger and much older women are less likely to seek skilled maternal care. Initiatives to improve SBA utilization must judiciously tackle poverty, remoteness, inconsistent quality care, and traditional mindsets. The county and national governments should implement policies that alleviate financial, and resource challenges and create health facilities in remote villages