Factors associated with quality of intrapartum care in Kenya: a complex samples analysis of the 2022 Kenya demographic and health survey

Abstract

Background Quality of intrapartum care remains a key intervention for increasing women’s utilization of skilled birth attendants in health facilities and improving maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS). Methods Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratified sampling, was used. Quality of intrapartum care was considered if a mother had a facility-based delivery, received skilled assistance during birth, and the baby immediately placed on the mother’s breast by skilled birth attendant within 1 hour after birth. We conducted multivariable logistic regression to determine the factors associated with quality of intrapartum care using SPSS (version 20). Results Of the 11,863 women who had recently given birth, about 52.6% had received quality intrapartum care. As part of the intrapartum care, 88.2% gave birth in a health facility, 90.4% obtained assistance from skilled birth attendants, and 59.8% had their babies placed on the breast by delivery assistants within 1 hour after birth. Women who had attained secondary education (aOR = 1.46, 95% CI: 1.23–1.90), were working (aOR 1.24, 95% CI: 1.00-1.53), had > = 3 living children (aOR = 1.31 ,95% CI: 1.02–1.68), took 31–60 minutes to reach the health facility (aOR = 1.49, 95% CI: 1.41–1.95), were assisted during child birth by doctors (aOR = 19.86, 95% CI: 2.89-136.43) and nurses/midwives/clinical officers (aOR = 23.09, 95% CI: 3.36-158.89) had higher odds of receiving quality intrapartum care. On the other hand, women in the richest wealth index (aOR = 0.64, 95% CI: 0.42–0.98), those who gave birth through cesarean section (AOR = 0.27, 95% CI: 0.20–0.36) and those whose current age of their child was > = 2years (AOR = 0.76, 95% CI: 0.60–0.96) were less likely to receive quality intrapartum care. Conclusions About half of the women received quality clinical intrapartum care in Kenya, with demographic characteristics seeming to be the main drivers of quality intrapartum care. There is need to empower women through increasing access to education and developing initiatives for their economic independence, as well as facilitating their increased access to skilled birth attendants to improve the quality of intrapartum care.