Use of maternal and child health services in a community with large refugee population in Nairobi, Kenya: a cross-sectional survey

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Abstract Background The population of urban refugees in the Eastleigh area of Nairobi, Kenya, is estimated at 100,000 to 150,000. Limited information on access to health care is available for this population. The health care a mother receives during pregnancy, at the time of delivery, and soon after delivery is important for the survival and well-being of both the mother and her child. The disadvantages in accessing health care and vulnerabilities of immigrant and refugee women are well documented in the literature. The purpose of our study was to assess the use of maternal and child health (MCH) services among the residents of Eastleigh and sources of services sought. Methods In July and August 2010, we surveyed households in Eastleigh. Households were chosen using a multistage cluster sampling design. A standard questionnaire on household demographics was administered to the household caretakers. If the household included a woman who delivered a baby or had a pregnancy that lasted at least 7 months within the past year, she responded to the MCH questionnaire separately. Results We gathered data from 673 households with 3,005 household members. There were 981 (32.6%) women of reproductive age (15–49 years), of whom 116 (11.8%) reported having a pregnancy or delivering in the past year. Of these 116 mothers, 104 (89.7%) made at least one antenatal care (ANC) visit, and 60 (63.2%) made at least four visits. Of 104 women who made at least one ANC visit, 23 (25.4%) first visited in the first trimester; 69 (64.2%) in the second trimester; and 13 (10.4%) in the third trimester. Compared with women who attended secondary school or higher, those with religious education only were twice as likely to get ANC in the early stages of pregnancy while those with no education were 3.33 times as likely. Fewer women (24%) sought delivery services at government health facilities than the 75% who delivered at private health facilities. Only three women delivered at home. Conclusion Use of MCH services was high among Eastleigh residents. Women actively sought care at numerous facilities, predominantly private ones. However, the quality of care in these private facilities requires further assessment.

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