Publication:

Utilization of individual birth plan during pregnancy and its determinants in Makueni County, Kenya

Background All pregnant women are required to have an individual birth plan (IBP) to be discussed during each antenatal care clinic (ANC) visit. Birth preparedness increases the likelihood of seeking skilled care which can lead to positive birth outcomes. However, there is paucity of literature on utilization of IBP in rural Kenya. This study aimed at assessing the level of utilization of IBP and it’s determinants in Makueni County, Kenya.

Methods Descriptive cross-sectional design was used to study 326 postnatal mothers in three primary health facilities. Systematic sampling technique was used. We collected data using a researcher-administered structured questionnaire and focused group discussion. Quantitative data analysis was conducted using statistical package for Social Sciences (SPSS) version 20.0 and involved univariate and bivariate analysis. Chi- square were used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis.

Results IBP utilization was low 48.2% (95% CI (42.7%-58.6%) despite high ANC attendance. Identifying a blood donor was the least utilized component (25%). Being middle aged, high education level, attending ANC clinic 4 times and being married were significantly associated with utilization of an IBP, (OR=2.108, p=0.005), (OR=12.828, p<0.001), (OR 30.942 (95% CI 4.128-231.954) p<0.001) and (OR=2.20, p=0.001) respectively. Perceptions of high cost, long distance and disrespect from staff reduced IBP utilization by 65%, 80% and 47% respectively.

Conclusions Birth preparedness is low despite high antenatal clinic attendance. Stakeholders ought to address factors influencing birth preparedness.