Determinants of utilization of skilled birth attendants among women of reproductive age (15-49 years) in Kakamega County, Kenya; a cross sectional study

Background Globally, about 800 women die daily from complications arising during labor or within 42 days of childbirth. These deaths can be prevented by ensuring that women give birth in a safe environment in the presence of Skilled Birth Attendants (SBAs). SBAs are efficient to manage pregnancy, child birth and postnatal complications or refer in very complicated cases. Only about half of the women use SBAs in Kakamega County, Kenya. The study aim was to describe the determinants of utilization of SBA in Kakamega County. Method A cross sectional design was used. Data was obtained from Multiple Indicator Cluster Survey (MICS) conducted in the year 2014. A sample of 295 women were selected through two-stage cluster sampling. Standardized questionnaire was used to collect data from women who had given birth two years prior to the survey. Univariate and multivariate analysis was used to analyze the data. Results There was an association for use of SBAs with lower parity Odds Ratio (OR) 3.11(95% CI,1.82-5.52), early Antenatal Care (ANC) attendance OR 0.49(95% CI,0.27-0.88), secondary education OR 1.89(95% CI, 1.16-3.05) and high wealth index OR 2.87(95% CI,1.76-4.69). There was no association with ANC visits OR 1.3 (95% CI, 0.80-2.24) and place of residence OR 1.50 (95% CI,0.93-2.41). Conclusion Being in higher quartile, exposure to secondary education and low parity were key influencers of SBA use while place of residence did not show any association. There is an association between use of SBA and timely ANC attendance but not with number of ANC visits