Naanyu Violet, Baliddawa Joyce, Koech Beatrice, Karfakis Julie, Nyagoha Nancy
Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University Eldoret, Kenya.
Academic Model Providing Access to Healthcare Program, Eldoret, Kenya.
Afr J Reprod Health. 2018 Mar;22(1):85-93. doi: 10.29063/ajrh2018/v22i1.8.
More than 95% of Kenyan women receive antenatal care (ANC) and only 62% access skilled delivery. To explore women's opinion on delivery location, 20 focus group discussions were conducted at an urban and rural setting in western Kenya. Participants included health care workers, traditional birth attendants (TBAs), and women who attended at least four ANC visits and delivered. Six in-depth interviews were also conducted with a combination of women who gave birth in a facility and at home. Discussions were digitally recorded and transcribed for analysis. Data was subjected to content analysis for deductive and inductive codes. Emergent themes were logically organized to address the study topic. Findings revealed that delivery services were sought from both skilled attendants and TBAs. TBAs remain popular despite lack of acknowledgement from mainstream health care. Choice of delivery is influenced by financial access, availability and quality of skilled delivery services, physical access, culture, ignorance about childbirth processes, easy access to familiar TBAs, fear of hospitals and hospital procedures, and social stigma. Appreciation of TBA referral role, quality maternity service, and reproductive health education can encourage facility deliveries. Formal and informal health workers should cooperate in innovative ways and ensure safe motherhood in Kenya.
超过95%的肯尼亚女性接受产前护理（ANC），但只有62%的人能够获得熟练的接生服务。为了探究女性对分娩地点的看法，在肯尼亚西部的城乡地区开展了20场焦点小组讨论。参与者包括医护人员、传统助产士（TBAs）以及至少接受过四次产前护理并已分娩的女性。还对在医疗机构和家中分娩的女性进行了六次深度访谈。讨论内容进行了数字录音并转录以供分析。对数据进行内容分析以得出演绎和归纳编码。将浮现出的主题进行逻辑组织以解决研究课题。研究结果显示，女性既会寻求熟练医护人员的接生服务，也会找传统助产士。尽管主流医疗保健机构并不认可，但传统助产士仍然很受欢迎。分娩地点的选择受到经济条件、熟练接生服务的可及性和质量、实际可达性、文化、对分娩过程的无知、容易找到熟悉的传统助产士、对医院和医院程序的恐惧以及社会耻辱感等因素的影响。认可传统助产士的转诊作用、优质的孕产妇服务和生殖健康教育可以鼓励在医疗机构分娩。正规和非正规卫生工作者应以创新方式合作，并确保肯尼亚的孕产妇安全。
