| dc.description.abstract | Health systems have failed in past epidemics to maintain routine essential services in
health. People, resources, and essential supplies all diverted to address health
emergency, sometimes resulting in lack of important basic and routine health services.
Pregnant women are at an increased risk for severe illness, preterm birth and other
adverse pregnancy outcomes from COVID-19 compared to non-pregnant women.
During emergency cases, disintegration of health care services can have a profound
effect as hospitals become strained or non-functional. Thus an outbreak of infectious
disease can catalyze further health problems in a community as populations lose
confidence in the available health facilities and significantly reduce usage of the
healthcare system. The purpose of this study was to determine factors that influenced
utilization of healthcare services among pregnant women and caregivers with children
below two years during COVID-19 pandemic. This was a retrospective cross-sectional
study with mixed data collection methods, where respondents were asked questions on
how COVID-19 affected them with regard to utilization of MCH healthcare during the
first peak of the COVID-19 in Kenya. Two high volume facilities were selected
purposively based on volume and capacity of services offered. A random sample was
drawn from the stratum using a list generated by Community Health Workers attached
to the health facilities.Key informant interviews were used to collect data among health
care providers and structured questionnaire was used for pregnant women and
caregivers. Chi-square test was used to test for significance at p-value 0.05.
Independent variables; social distancing, social stigma, communication and human
mobility restriction were associated with health care service utilization and significant
at 0.05 p-value. Correlation analysis indicated Social stigma (-.407, p<.512), social
distancing (-.324, p<.001) and human mobility restrictions (-.606, p<.001) negatively
influenced service utilization. Whereas COVID-19 related communication (.631,
p<0.001) was protective and thus promoted service utilization. The hierarchical linear
regression model explained 67.73% of the total variations in the health care service
utilization, which is r = 0.6773. The study recommends that Migori County Department
of Health should i) to develop risk communication plan to sensitize the community
against stigma ii) use main media channels and develop measures against fake news,
iii) Strengthening targeted community outreaches for pregnant women and caregivers
with children under two years iv) develop referral networks and transportation
mechanisms to improve facility-community connections during lockdown and past
curfew hours. | en_US |
