An Examination of the factors influencing the mode of child delivery in Nairobi County
Date
2021
Authors
Karori, Catherine
Journal Title
Journal ISSN
Volume Title
Publisher
Strathmore University
Abstract
Kenya has a female population of approximately 25.8 million people according to the World Bank 2018 data (50.32% of the total population). Of these, 25.4% are of childbearing age between ages 15 to 49 (6.5 million). During childbirth, the women deliver at various healthcare facilities including at home, and undergo two main types of delivery: vaginal birth (normal delivery) or cesarean section (C-section) delivery. The recommended form of child delivery is a normal delivery. World Health Organization (WHO) recommends that C-section surgeries be carried out only when medically necessary. The international healthcare community recommends a C-section rate of I 0 - 15%. There continues to be growing global concern however about the increased rate of C-section deliveries. This research sought to study the growing trend of C-section rates using a study of Nairobi County in Kenya with a specific focus on examining the factors influencing the mode of child delivery. The study obtained data from several health facilities in Nairobi County. The data relates to the records of patients for the last thirty-six (36) months who have delivered by way of normal delivery or C-section and the classification of the patients by some of the key influencing factors for example the pre-payment mechanisms which include National Hospital Insurance Fund (NHIF), private health insurance and others. This was supported by questionnaires aimed at obtaining information on another key factor influencing the mode of child delivery being the characteristics of the women who opt for different modes of delivery namely normal delivery and C-section. The study aimed to provide recommendations on how best practices identified locally and globally can be implemented by the various stakeholders to achieve long-term sustainable models in healthcare while ensuring quality, accessible, and cost-effective healthcare services. In addition, the study sought to reinforce that sections be carried out only when medically necessary in the best interest of the maternal health practice and the various stakeholders. The findings indicated that there was a significantly positive correlation between key influencing factors like prepayment mechanisms and medical personnel on the mode of child delivery. The coefficient results pointed to a significant relation of medical personnel to the mode of child delivery. The independent T-test results indicated that there was a significant mean difference between the amount paid through cash and insurance. The study concluded that prepayment mechanisms and medical personnel have a statistically significant relationship with the mode of child delivery. However, when combined with other variables, prepayment mechanisms did not have a significant predictive ability to influence the mode of child delivery. In addition, the study concluded that in terms of financial implications, women who opted for prepayment mechanisms such as NHIF, corporate insurance, or private personal insurance were likely to pay more compared to those who opted for cash payment. The study recommended that the prepayment mechanisms, as a key influencing factor, enforce policies and guidelines including strategic purchasing models with healthcare service providers including medical doctors, and define acceptable levels of C-section deliveries.
Description
A research project submitted in partial fulfilment of the requirements for the degree of Postgraduate in Business Administration in Healthcare Management