Trends and determinants of health facility childbirth service utilization among mothers in urban slums of Nairobi, Kenya

High maternal mortality remains a challenge for the attainment of the third Sustainable Development Goal in Sub-Saharan Africa. In Kenya, maternal mortality ratio remains high at 362 deaths per 100,000 live births. Utilization of health facility childbirth services ensures safe birth and is vital for the reduction of maternal mortality. However, this can be greatly affected by socioeconomic and geographical inequalities. In this study, we assess the trends and determinants of health facility childbirth service utilization among women giving birth in the urban slums of Nairobi, Kenya. Data were obtained from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) comprising 19,469 births observed between 2003 and [19]. A logistic regression model, with parameter estimation using a generalized estimating equations (GEE) approach, was used to assess factors associated with health facility childbirth. About 81% of the births occurred at health facilities while 19% were occurring at home or outside a health facility. The results further indicated that, education, parity, and relationship to head of households were associated with health facility childbirth. Increasing awareness of the mothers about the benefits of health facility childbirth service utilization and the risks of home childbirth should be given extra attention by health practitioners during antenatal care visits.