title: Utilisation of antenatal and maternity services by mothers seeking child welfare services in Mbeere District, Eastern Province, Kenya.
abstract: BACKGROUND
  Utilisation of antenatal and maternity services is an important maternal health indicator. Increasing the proportion of mothers who are cared for in health facilities during pregnancy, childbirth and puerperium reduces the health risks to mothers and their children.
  
  
  OBJECTIVE
  To determine the utilisation of antenatal and maternity services by mothers of Mbeere District bringing their children to the child welfare clinic.
  
  
  METHODS
  Cross-sectional, descriptive study.
  
  
  METHODS
  Four rural health centres in Mbeere district.
  
  
  METHODS
  Two hundred mothers bringing their children aged one year and below to the child welfare clinic between September and December 2000.
  
  
  RESULTS
  The proportion of mothers who utilised health facilities for antenatal and maternity services was 97.5% and 52%, respectively. Utilisation of health facilities for maternity services was significantly influenced by number of children and distance to health facility in that, as number of children increased, utilisation of maternity services reduced (chi2=8.99; p=0.027; df=1). Mothers living less than 5 km to a health facility utilised the services better than those living 5 km and beyond (chi2=7.57; p=0.0059; df=1). Among the reasons given by the mothers (individual respondents and through Focus Group Discussions) regarding dissatisfaction with the services offered included shortage of drugs and essential supplies, lack of commitment by staff, poor quality of food and lack of cleanliness in the health facilities.
  
  
  CONCLUSIONS
  Coverage for antenatal services was high among mothers during their last pregnancy. However, only about half of the mothers interviewed utilised health facilities for maternity services (labour and delivery). The major constraints experienced by the mothers as they sought for the services (as reported by individual respondents and through Focus Group Discussions) included lack of transport, lack of money for transport and hospital fee and delay in admission to health facility once mothers report in labour. Lack of satisfaction with quality of care given could be the major demotivating factor in the use of health facilities for maternity services.
authors.affiliation: Kenyatta University, P O Box 43844, Nairobi.
authors.forename: P K
authors.initials: PK
authors.lastname: Mwaniki
authors.forename: E W
authors.initials: EW
authors.lastname: Kabiru
authors.forename: G G
authors.initials: GG
authors.lastname: Mbugua
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D007630:Kenya; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data; D008875:Middle Aged; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012111:Residence Characteristics / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires