Effects of computed distances, and other determinant factors on place of child delivery in Magadi Ward, Kenya

Abstract

The choice of place of delivery is still debatable in most sub-Saharan African societies’ especially pastoral communities. The decision on whether to deliver at a health facility or at home varies across households. This study sought to evaluate the effects of computed distance, demographic and socio-economic factors on the place of child delivery in rural Magadi, Kenya. The integration of both spatial and statistical techniques was adopted. Distances (straight-line distance, road network distance to the nearest health facility and primary facility) were computed using tools in the Network Analyst toolbox. Computed distances of 246 sampled households together with demographic and socioeconomic factors were further analysed using univariate and multivariate logistic regression. The findings showed that calculated road network distance to the primary facility was a determinant of access and use of place of delivery both for the adjusted and the unadjusted odds. Women aged 20 years or below, having more children, secondary education or above and those who are unmarried are more likely to deliver at health facility. Receiving 1 or 2 childbirth services from a health facility, being aware of a private actor who set up the health facility and involvement of the spouse in the decision-making of place of birth are also linked to the use of health facility for child delivery. Deliveries at home were related to family monthly income level, family occupation, opinion on health facility location and being aged between 21 – 30 years. It was found that though computed road distance to the primary facility was the dominant factor, other variables such as level of education, parity, awareness of local actors, other childbirth services received prior to child delivery and marital status determined whether a woman would access and use health facilities for child delivery.