DETERMINANTS OF UTILIZATION OF EMERGENCY OBSTETRIC CARESERVICES AMONG POST-NATAL WOMEN SEEKING CARE AT SAMBURUCOUNTY REFERRAL HOSPITAL, SAMBURU COUNTY, KENYA

Abstract

Background: Over 295,000 women's deaths and 1.9 million premature births worldwide are attributed to complications related to pregnancy and delivery each year, many of which are avoidable. The study aimed to assess the determinants of utilization of emergency obstetric care services among postnatal women seeking care at Samburu County Referral Hospital, Samburu County, Kenya.

Methods: A mixed-methods research design incorporating both quantitative and qualitative approaches was used in this study. Systematic and simple random sampling were used to select study participants. Using chi-square analysis and binary logistic regression, the relationship between the independent and dependent variables was evaluated. The statistical significance threshold for quantitative data analysis was set at p ≤ 0.05, and SPSS version 27 was used for analysis. Utilizing thematic analysis, the qualitative data were examined.

Results: Among 283 study participants, close to three-quarters (n=202, 71.4%) had utilized Emergency Obstetric Care (EmOC) services. Seeking Antenatal Care Uptake (ANC) (OR=3.8, 95% CI=1.13-4.17, < 0.001), Having pregnancy complications(OR=7.2, 95% CI=1.07-9.27,p=0.003), taking between 1-30 minutes to the hospital (OR=2.5, 95% CI=1.005-3.143,p< 0.001), and social support(OR=4.5, 95% CI=2.49-8.29,p< 0.001), being satisfied with healthcare services(OR=4.6, 95%

CI=1.09-5.56,p=0.002) and having a health insurance coverage (OR=4.7, 95% CI=1.78-12.12,p=0.002) increased the odds of utilizing EmOC services. In contrast, peer pressure (OR=0.43, 95% CI=0.196-0.502, p-value=0.013) reduced the odds of using EmOC services.

Conclusion: The Majority of the respondents utilized EmOC services. Factors increasing utilization included attending ANC, pregnancy complications, proximity to the hospital (1-30 minutes), social support, satisfaction with healthcare services, and health insurance. However, peer pressure negatively impacted EmOC uptake. These findings emphasize the need for accessible, supportive, and community-oriented healthcare systems.