Determinants of Choice of Health Care for Maternal Health Services Among Women in a Rural Setting in Kayunga District.

Abstract

Background: The study was set out to determine the choice of health care for maternal health services among women in a rural setting, Kayunga district. Objectives: It was guided by four objectives; To determine the individual attributes of choice of health care for maternal health services among women in a rural setting, Kayunga District, To establish the traditional health beliefs on choice of health care for maternal Health Services among women in a rural setting, Kayunga District, To assess the socio-cultural determinants of choice of health care for maternal Health Services among the women in a rural setting, Kayunga District and To determine the Health care Factors affecting the choice of health care for Maternal Health Services among women in a rural setting, Kayunga District. Methodology: A descriptive cross sectional study was used. The sampling procedures used were purposively, multi-stage sampling and systematic random sampling. Primary data was obtained through structured questionnaires which were filled by key respondents who were women of reproductive age. Secondary data was obtained through key informant interviews that generated relevant data from health workers in health facilities within the study area. The study population comprised of women of reproductive age 15-49. Both qualitative and quantitative methods were used. A total of 198 respondents were interviewed using semi-structured questionnaires and key informants interviews were conducted. The study inclusion criteria involved only women between 15-49 years old residing in Kayunga district, and those that provided an informed consent and health workers. The exclusion criteria involved men, women below 15 years and women above 49 years and those that didn‘t provide consent. Data quality was ensured through validity and reliability. Data obtained was analyzed using SPSS (statistical package for social scientists) at a univariant, bi-variant and multi variant level and a p-value<0.05 was considered statistically significant. Results: There was a large proportion of self-employed women who had both visited and not visited a TBA respectively i.e. 65.8% vs 53.2% .However among the housewife‘s, a large proportion had never visited a TBA 26(23.4%) compared to only 4(10.5%) who had ever and this was significant with p value (0.038 ,p<0.05). The majority of the respondents who earned considerably low incomes of between 5,000-10,000, 10,001-50,000 and 50,001-100,000 were more likely to have not visited the TBA compared to those with higher incomes of >300,000.This was very significant with p-value (0.001,p<0.05) At multi-variate level this study found out that Women who were unemployed have reduced odds0.09 (p-value0.040<0.05) on unadjusted of going to traditional attendants which is significant compared to the fully employed but on adjusting it is not significant (p-value0.20>0.05s) odds ratio 0.20. And those earning incomes between 5000-10000 had lower odds of going to a traditional attendant compared to those less than 5000. This was significant when adjusted (p-value 0.019<0.05) odds ratio 0.05. Conclusion: The individual attributes of level of earning and occupation had a strong association with the choice of health care for maternal health service in Kayunga district. Recommendation: The government and other stakeholders should create more employment opportunities to increase income earning levels of rural women in Kayunga district, this will positively impact on the choice of health care for maternal health services.