Evaluating the impact of a care model on skilled delivery service utilization among women in Kandara, Murang'a County, Kenya

Abstract

BACKGROUND

Addressing maternal and neonatal mortality rates in Kenya requires improving skilled delivery services, as unskilled deliveries contribute significantly to negative maternal and child health outcomes. This study aimed to evaluate the effectiveness of a model of care designed to enhance the utilization of skilled delivery services among women of reproductive age in the Kandara sub-county, Murang’a County, Kenya.

MATERIALS AND METHODS

Using a quasi-experimental study design, 154 pregnant women in their second trimester were equally assigned to test and comparison groups. The test group received tailored strategies promoting skilled birth attendance, while the comparison group received standard antenatal care. Data were collected continuously from the 28th week of gestation until delivery. Interventions for the test group included education on skilled delivery benefits and improved access to skilled attendants. All participants completed follow-up, achieving a 100% response rate.

RESULTS

Skilled birth attendance significantly increased in the intervention group compared to the comparison group. The intervention group had 98.7% skilled deliveries, while the comparison group had 85.7%. The overall proportion of skilled deliveries across both groups was 88%. Statistical analysis (Z = 3.08, p = 0.002) supports these findings, resulting in the rejection of the null hypothesis.

CONCLUSION AND RECOMMENDATIONS

The tested model of care proved effective, suggesting its potential for implementation in low-skilled delivery areas. Collaborative efforts involving the National and county governments through the health departments, NGOs, and community health workers are recommended to scale up implementation in maternal and neonatal care. Advocacy with policymakers is crucial for integrating the model into maternal healthcare systems and shaping supportive policies. Additionally, government and stakeholder research collaborations are recommended to evaluate the model's long-term impact and sustainability.