Determinants Of Bypassing County Public Health Facilities Among Women Seeking Childbirth Services At The Moi Teaching And Referral Hospital, Eldoret

ABSTRACT

Strong preferences are revealed when patients fail to utilize their nearby facilities and

seek health care services at another facility. Bypassing rates for childbirth has been

documented in literature and it ranges between 30% and 70 %. At Moi Teaching and

Referral Hospital similar observation is made with majority of the women delivering at

the facility having bypassed their nearby county health facilities. Thus, the current study

sought to identify the individual and health facility factors that inform a woman’s decision

to bypass county public health care facilities and seek childbirth services at Moi Teaching

and Referral Hospital. A health facility based cross sectional study was conducted using

quantitative approach of data collection. A total of 399 respondents were incorporated in

the study. The independent variables studied were maternal age, marital status, level of

education, occupation, parity, and previous pregnancy history, level of care at the public

health facility, functionality of health facilities and ease of access of the nearest health

facility. The dependent variable was bypassing health facilities. Descriptive statistics,

bivariate and multivariate logistic regressions were used in data analysis. A p value less

than 0.05 was considered statistically significant at 95% confidence interval. Results

obtained showed that out of the 399 study participants, 76.7% of the women who

delivered at Moi Teaching and Referral Hospital bypassed their nearby health facilities.

Among the individual characteristics that significantly influenced bypassing were home

county of residence (OR: 4.9; 95% CI: 2.2-11.1; p= 0.0001), having received ANC at

MTRH (OR: 9.6; 95% CI: 8.1-14.6; p=