title: Barriers to access of maternity care in kenya: a social perspective.
abstract: OBJECTIVE
  In response to high maternal mortality rates, the global community has rallied to improve the state of maternal health worldwide. However, progress towards the fifth Millennium Development Goal, "Improve Maternal Health," has been disappointingly slow. There is a pressing need to address the factors that contribute to maternal mortality, one of which is access to care. This health demand is particularly urgent in countries in sub-Saharan Africa, where maternal mortality is disproportionately high compared with developed countries. The aim of this study was to explore the perceptions rural women have about barriers to access to maternity care in Asembo Bay, Kenya.
  
  
  METHODS
  We conducted interviews with individuals and convened a focus group of lay women and care professionals. The results of the interviews and focus group were then analyzed thematically.
  
  
  RESULTS
  Common social themes that emerged related to women's access of maternity care in this population included fears associated with HIV testing or disclosure of HIV status, gender inequalities, and attitudes towards facility-based care.
  
  
  CONCLUSIONS
  Data and themes in this study are consistent with previous research and provide a descriptive account of the barriers that prevent rural Kenyan mothers from accessing health care throughout their pregnancies. Each barrier explored here translates into an area of improvement where focus is needed to increase access to care and, ultimately, to reduce maternal mortality in this setting.
authors.affiliation: Omni Research Group, Ottawa Hospital Research Institute, Ottawa ON.
authors.forename: Laura
authors.initials: L
authors.lastname: Byford-Richardson
authors.affiliation: Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa ON.
authors.forename: Mark
authors.initials: M
authors.lastname: Walker
authors.affiliation: Faculty of Health Sciences, University of Ottawa, Ottawa ON.
authors.forename: Wendy
authors.initials: W
authors.lastname: Muckle
authors.affiliation: BORN Ontario, Ottawa ON.
authors.forename: Ann
authors.initials: A
authors.lastname: Sprague
authors.affiliation: Department of Kinesiology and Health Studies, Queens University, Kingston ON.
authors.forename: Stevenson
authors.initials: S
authors.lastname: Fergus
authors.affiliation: Omni Research Group, Ottawa Hospital Research Institute, Ottawa ON.
authors.forename: Ruth
authors.initials: R
authors.lastname: Rennicks White
authors.affiliation: Asembo Bay Women's Development Centre, Asembo Bay, Kenya.
authors.forename: Bertha
authors.initials: B
authors.lastname: Dick
mesh_terms: D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya; D008427:Maternal Health Services; D008428:Maternal Mortality; D010465:Perception; D011247:Pregnancy; D012424:Rural Population; D063507:Sexism; D012959:Socioeconomic Factors