Delays in Africa Accessing Emergency Obstetric Care in Sub-Saharan; Kenya Situation

Abstract

Delay in accessing facility for delivery by a skilled person has huge impact on maternal health outcomes in developing countries. However, women’s deaths at birth in Sub-Saharan countries remain high due to challenges associated with accessing immediate Emergency Obstetric Care (EmOC) at birth.

While the deaths are preventable through availability of EmOC and skilled persons attending to delivery, access to these services remain poor and most women continue to give birth at home without the assistance of a skilled person.

The purpose of the study was to identify barriers to accessing EmOC in order to suggest ways of increasing skilled birth attendance in Kenya, a strategy that is known to reduce maternal mortality and morbidity. Relevant literature from abstracts of scholarly journals from major search engines were scanned and analyzed for results.

Significant factors that were identified to cause delay in accessing EmOC are maternal education, financial status, ignorance, delay in decision making by family, preference for Traditional Birth Attendants (TBA), travel cost, means of transport, distance, and impassable roads. Further barriers are poor quality of care due to supplies and equipment shortage, rude, unwelcoming staff, user fees paid on admission and long waiting hours in the facilities.

Based on the findings, various barriers that hinder women from accessing EmOC exist. To increase the number of births assisted by skilled professionals and reduce maternal deaths, these barriers need to be tackled from family, community, and facility levels.

The recommendations include community sensitization and health education on pregnancy related danger signs, strengthening of health care systems to ensure availability of supplies, equipment, and improving referral systems. Integration of TBAs role to health care system will ensure timely referral and increased facility deliveries.