Maternal Autonomy, Distance to Health Care Facility and ANC Attendance: Findings from Madiany Division of Siaya County, Kenya

Half a million women die annually from pregnancy related causes. In Kenya, maternal mortality ratio (MMR) remains high in spite of great efforts to improve maternal health care. We studied some factors linked to maternity in a rural community setting. A survey was conducted in the community living in Madiany division of Siaya County, Kenya. We randomly sampled 403 mothers of children under three years old. Variables of interest were antenatal care attendance (ANC), parity, distance from the health facility and women empowerment (autonomy). Nearly 94% of the mothers had at least one ANC visit and 48.6% had completed the recommended four or more ANC visits; about 65.7% initiated ANC at first trimester. Parity, distance to the health facility and autonomy were associated with ANC visits. Mothers with one child had a twice higher chance of at least four ANC visits than those with more than one child. Those living at most 60 minutes travel-time from the health facility were seven times more likely have early ANC initiation and five times more likely to have at least four ANC attendance than those living more than 60 minutes travel-time from the health facility. Autonomy was linked to early initiation of ANC visit. This may indicate that improving maternal care and achieving Millennium Development Goal (MDG) 5 target, it is important to improve coverage of health facilities and implement development programs that empower rural women.