Individual and contextual factors affecting maternal health care utilization in Mandera County in Kenya: a mixed methods analysis

Sam W. Wafula, SNV Netherlands

This paper examines the individual and contextual factors that affect utilization of three aspects of maternal health care: place of delivery, contraceptive use and child immunization. Primary data were collected using a two stage cluster sampling approach in Mandera County -one of the remotest counties in Kenya. Low levels of maternal education, husband disapproval, deep religious and cultural beliefs, lean staff at health facilities and deep trust in Traditional birth attendants (TBAs) were found to be significantly associated with low utilization of maternal and child health services (p value<0.05). The study calls for a re-orientation of the role of TBAs in health care provision, investment in human resources for health, increase in maternal education as well as community sensitization campaigns as means of accelerating uptake of maternal health services.