Aims: A survey carried out in the maternity centre of a Kenyan county hospital sought to evaluate the institutional factors influencing women's perception of quality of intrapartum care. Methods: This cross-sectional quantitative and qualitative study involved 195 postpartum mothers, who were randomly sampled. A questionnaire, a focus group discussion and a key informant interview were used to collect data. Findings: The study indicated that there was a positive relationship between women's perceptions of quality of intrapartum care and institutional factors, such as cost of services and comfort in waiting rooms (P = 0.007 and 0.025, respectively). Residing near a hospital was also associated with a positive perception of the quality of intrapartum care. Conclusions: This study reveals that it is important to provide an affordable and accessible environment during childbirth to improve the women's perception of quality of care provided during this period. This study's findings have implications in the design of maternity centres and the implementation of free maternity services in Kenya.

Background/Aims Utilisation of skilled care delivery remains low in developing countries, including Kenya. Literature shows that predictors of skilled birth attendance differ from region to region. This study aimed to identify predictors of skilled birth attendance for delivery among women in Bomachoge Chache, Kenya. Methods This was a case control study conducted in 2015, in Bomachoge Chache Sub County, Kisii County, Kenya. The study targeted postnatal mothers who brought their children for immunisation. A total of 322 postnatal mothers (n=161 delivered at home; n=161 delivered in a health facility) answered questions about sociodemographic characteristics on a pretested researcher-administered questionnaire. Association of characteristics with skilled birth attendance was analysed using the chi square test. Multivariate logistic regression was used to determine the strength of the associations and to control for confounders, with significance assumed at P<0.05. Results The likelihood of mothers delivering at home was higher in mothers who had two or more children (adjusted odds ratio=28.4, P=0.0005) and in mothers whose spouses were casual labourers (adjusted odds ratio=16.9, P=0.0048). However, the likelihood of delivering at home was lower in mothers who had at least secondary level education (adjusted odds ratio=0.33, P=0.03) and in mothers who were farmers (adjusted odds ratio=0.32, P=0.03). Conclusions Sociodemographic characteristics including parity, occupation, spousal occupation and education impact the use of skilled care at birth and should be evaluated to inform policy for maternal and neonatal care. Further studies at a household level are recommended to fully understand disparities in skilled attendance at birth.

Knowledge of antenatal care is important in reducing maternal mortality and morbidity. Mobile phones have demonstrated an increase in the use of antenatal care services. However, few studies have indicated the effectiveness of health education on antenatal care via mobile phone calls. In this study, we aimed to evaluate the effectiveness of health education on antenatal care provided through mobile phone calls among pregnant women in Kisii County, Kenya. A total of 160 pregnant women up to 26 weeks of gestation were recruited for the study from 16 sub-county health facilities (clusters) in Kisii County. The women were enrolled in their first visit and followed up until delivery. The sub-county health facilities were randomly assigned to either intervention or control arms. The intervention involved giving health education on antenatal care through mobile phone calls. All the participants in both study arms received routine antenatal care. However, those enrolled in the intervention sites additionally received health education through mobile phone calls. The primary outcome measure was antenatal care knowledge scores. Baseline and end-of-study questionnaires were used to collect data. Women in the intervention group scored highly in antenatal care knowledge post-intervention as compared to those in the control group, 7.87 (SE of the difference = 0.68, p-value < 0.001, 95% CI (6.53–9.20). Health education delivered through mobile phone calls has great potential in improving antenatal care knowledge.