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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

Open Access 01-12-2020 | Care | Research article

Geographical accessibility in assessing bypassing behaviour for inpatient neonatal care, Bungoma County-Kenya

Authors: Ian A. Ocholla, Nathan O. Agutu, Paul O. Ouma, Daniel Gatungu, Felistas O. Makokha, Jesse Gitaka

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

Neonatal mortality rate in Kenya continues to be unacceptably high. In reducing newborn deaths, inequality in access to care and quality care have been identified as current barriers. Contributing to these barriers are the bypassing behaviour and geographical access which leads to delay in seeking newborn care. This study (i) measured geographical accessibility of inpatient newborn care, and (ii), characterized bypassing behaviour using the geographical accessibility of the inpatient newborn care seekers.

Methods

Geographical accessibility to the inpatient newborn units was modelled based on travel time to the units across Bungoma County. Data was then collected from 8 inpatient newborn units and 395 mothers whose newborns were admitted in the units were interviewed. Their spatial residence locations were geo-referenced and were used against the modelled travel time to define bypassing behaviour.

Results

Approximately 90% of the sick newborn population have access to nearest newborn units (< 2 h). However, 36% of the mothers bypassed their nearest inpatient newborn facility, with lack of diagnostic services (28%) and distrust of health personnel (37%) being the major determinants for bypassing. Approximately 75% of the care seekers preferred to use the higher tier facilities for both maternal and neonatal care in comparison to sub-county facilities which mostly were bypassed and remained underutilised.

Conclusion

Our findings suggest that though majority of the population have access to care, sub-county inpatient newborn facilities have high risk of being bypassed. There is need to improve quality of care in maternal care, to reduce bypassing behaviour and improving neonatal outcome.
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Metadata
Title
Geographical accessibility in assessing bypassing behaviour for inpatient neonatal care, Bungoma County-Kenya
Authors
Ian A. Ocholla
Nathan O. Agutu
Paul O. Ouma
Daniel Gatungu
Felistas O. Makokha
Jesse Gitaka
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-02977-x

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