HEALTH FACILITY FACTORS AND INDIVIDUAL FACTORS AS PREDICTORS OF UPTAKE OF SKILLED BIRTH SERVICES IN LURAMBI SUB COUNTY, KENYA.

Introduction: Factors determining maternity services utilization are diverse and yet interrelated. They can be grouped into five main factors namely socio cultural factors, Physical access, and economic access, past obstetric experience and perceived benefit or quality of care. Objective: To determine predictors of uptake of skilled birth services in Lurambi sub-County. Methodology: A descriptive cross-sectional study adopting Quantitative methods. The study was carried out in Kakamega County and Sampling frame consisting of all the 17 government facilities were used. A multistage stratified sampling strategy was used and Probability sampling technique of systematic sampling applied to select women seeking health facility delivery services in Lurambi sub county government facilities (n = 200). Data was analyzed through descriptive statistics, chi-square test and logistic regression. Results: The majority of the women were aged 20-35 years (70.5%) and 66% were married. About 40% had 1-2 children and majority had attained secondary education at 48.5% as the highest educational level. A majority of the women were business people at 25.5% and CHVs have a bigger role in deciding where the mothers deliver at 42%. Majority of the mothers 77.5% were less wealthy and a majority of them attended the ANC clinic at 98.5%. Chi square analysis showed that there was no statistically significant relationship between the skilled service delivery and age X2 (1, N=200) =0.22, p>0.05. Multinomial logistic regression was done, and the results showed people with one to two children were 1.7 times more likely (OR=1.17, 95% C.I, 0.4-3.8) to belong to the ?poor birth service? group than the ?good birth service? group compared to respondents who had seven children and above. With regards to marital status, respondents who were divorced from their spouses received good birth services (66.7%), while majority of the married people received poor birth services (55.6%). Results from chi square test showed that there was a statistically significant relationship between marital status and uptake of skilled birth service X2 (4, N=248) =39.109, p<0.05. Bivariate analysis on health facility related factors that are associated with uptake of skilled service delivery showed that there was a borderline significant relationship between delivery place and uptake of skilled birth service in the study area (OR: 0.8; 95% CI: 0.6 ? 1.2; p=0.02) Conclusion and Recommendation: Demographic factors like age, marital status, number of children and education level determine whether a woman would deliver in hospital or not.The factors are key players in women?s ability to uptake skilled birth services. It is recommended that sensitization of the elderly women and adolescent girls be done on importance of early access of antenatal clinic and hospital delivery through the community health volunteers.