Childbirth is not a Sickness; A Woman Should Struggle to Give Birth : Exploring Continuing Popularity of Home Births in Western Kenya.

More than 95% of Kenyan women receive antenatal care (ANC) and only 62% access skilled delivery. To explore women‘s opinion on delivery location, 20 focus group discussions were conducted at an urban and rural setting in western Kenya. Participants included health care workers, traditional birth attendants (TBAs), and women who attended at least four ANC visits and delivered. Six in-depth interviews were also conducted with a combination of women who gave birth in a facility and at home. Discussions were digitally recorded and transcribed for analysis. Data was subjected to content analysis for deductive and inductive codes. Emergent themes were logically organized to address the study topic. Findings revealed that delivery services were sought from both skilled attendants and TBAs. TBAs remain popular despite lack of acknowledgement from mainstream health care. Choice of delivery is influenced by financial access, availability and quality of skilled delivery services, physical access, culture, ignorance about childbirth processes, easy access to familiar TBAs, fear of hospitals and hospital procedures, and social stigma. Appreciation of TBA referral role, quality maternity service, and reproductive health education can encourage facility deliveries. Formal and informal health workers should cooperate in innovative ways and ensure safe motherhood in Kenya.Keywords: Delivery decision; Traditional birth attendants; Skilled delivery; Focus group discussions; Keny

An examination of postpartum family planning in western Kenya: I want to use contraception but I have not been told how to do so

Postpartum family planning (FP) in Kenya is low due to inadequate sensitization and awareness among women, particularly in rural areas. This paper identifies most widely used types of FP, intent and unmet needs among women, FP counseling and barriers to FP uptake. Focus group discussions with providers, traditional birth attendants (TBAs) and mothers, as well as in-depth interviews identify key themes including preferred postpartum FP, limits to existing FP counseling and barriers to FP uptake. Postpartum FP is common including injectable contraceptives, oral contraceptives, coils, condoms, and calendar methods. FP counseling is provided by peers, friends, TBAs and formal health providers. FP practices are associated with family support, literacy, access to FP information, side effects, costs and religion. In conclusion, changes in service provision and education could encourage increase in postpartum FP use in Kenya.La planification familiale du post-partum (PF) au Kenya est faible en raison de la sensibilisation insuffisante et la sensibilisation des femmes, en particulier dans les zones rurales. Ce document identifie les types les plus répandus de la PF, l'intention et les besoins non satisfaits chez les femmes, la consultation de la PF et les obstacles à l'adoption de la PF. Des discussions à groupe cible avec les prestataires de services, les accoucheuses traditionnelles (AT) et des mères, ainsi que des entrevues en profondeur dégagent les principaux thèmes, y compris la PF du post-partum préféré, les limites de la consultation de la PF en cours et les obstacles à l'adoption de la PF. La PF du Post-partum est commune, y compris les contraceptifs injectables, les contraceptifs oraux, les bobines, les préservatifs et les méthodes de calendrier. La consultation de la PF est prodiguée par des pairs, les amis, les accoucheuses traditionnelles et les prestataires officiels de santé. Les pratiques de la PF sont associées avec le soutien de la famille, l'alphabétisation, l'accès à l'information sur la PF, les effets secondaires, les coûts et la religion. En conclusion, les changements dans la prestation de services et de l'éducation pourraient encourager la hausse de l’utilisation de la PF du postpartum au Kenya

An examination of postpartum family planning in western Kenya: “I want to use contraception but I have not been told how to do so”

Postpartum family planning (FP) in Kenya is low due to inadequate sensitization and awareness among women, particularly in rural areas. This paper identifies most widely used types of FP, intent and unmet needs among women, FP counseling and barriers to FP uptake. Focus group discussions with providers, traditional birth attendants (TBAs) and mothers, as well as in-depth interviews identify key themes including preferred postpartum FP, limits to existing FP counseling and barriers to FP uptake. Postpartum FP is common including injectable contraceptives, oral contraceptives, coils, condoms, and calendar methods. FP counseling is provided by peers, friends, TBAs and formal health providers. FP practices are associated with family support, literacy, access to FP information, side effects, costs and religion. In conclusion, changes in service provision and education could encourage increase in postpartum FP use in Kenya.La planification familiale du post-partum (PF) au Kenya est faible en raison de la sensibilisation insuffisante et la sensibilisation des femmes, en particulier dans les zones rurales. Ce document identifie les types les plus répandus de la PF, l'intention et les besoins non satisfaits chez les femmes, la consultation de la PF et les obstacles à l'adoption de la PF. Des discussions à groupe cible avec les prestataires de services, les accoucheuses traditionnelles (AT) et des mères, ainsi que des entrevues en profondeur dégagent les principaux thèmes, y compris la PF du post-partum préféré, les limites de la consultation de la PF en cours et les obstacles à l'adoption de la PF. La PF du Post-partum est commune, y compris les contraceptifs injectables, les contraceptifs oraux, les bobines, les préservatifs et les méthodes de calendrier. La consultation de la PF est prodiguée par des pairs, les amis, les accoucheuses traditionnelles et les prestataires officiels de santé. Les pratiques de la PF sont associées avec le soutien de la famille, l'alphabétisation, l'accès à l'information sur la PF, les effets secondaires, les coûts et la religion. En conclusion, les changements dans la prestation de services et de l'éducation pourraient encourager la hausse de l’utilisation de la PF du postpartum au Kenya