Advisor(s)
Allyson Hall
Committee Member(s)
Anna Helova
Janet Turan
Kristine Hearld
Monica Aswani
School
School of Health Professions
Document Type
Dissertation
Department (new version)
Administration/Health Services
Date of Award
9-9-2024
Abstract
Maternal and Child Health (MCH) services, including antenatal care (ANC), postnatal care (PNC), and HIV services are crucial in preventing adverse pregnancy outcomes for pregnant/postpartum women and their infants. However, the utilization of these services remains low for pregnant/postpartum women living in Africa. The recent COVID-19 pandemic with the associated low utilization of MCH services poses a threat to the improvements made over the years. This dissertation proposal aimed to examine the relationship between HIV status and health service utilization (HSU) and outcomes for pregnant/postpartum women living in a rural region in Kenya. I adopted a convergent parallel mixed methods design to explore the study aims. Quantitatively, I examined the association between HIV status and health service utilization/health outcomes of pregnant and postpartum women. Using qualitative methods, this study also explored the disruptions in HSU and health service delivery from the perspectives of MCH workers during COVID-19 and other local crises. In general, MCH use was high in the quantitative sample. The results indicated that HIV status was only statistically significant in increasing the likelihood of having a high PNC utilization. Other factors that were significant for high MCH service use were early initiation of ANC visits and practical support from husbands. Factors that decreased the utilization of MCH services were living in the rural area and HSU decision-making by both partners. Being recruited during/after the pandemic was associated with both high HSU in PNC and low infant HIV testing. There were mixed responses in qualitative results where health workers reported a disruption and underutilization of MCH health services during the COVID-19 pandemic. They reported that fear and financial constraints were major reasons why they observed underutilization in MCH services during the pandemic. The findings of this study highlight the determinants of using MCH services for pregnant/postpartum women living in rural areas and how a global crisis like the COVID-19 pandemic can be disruptive to seeking healthcare. The result of this study suggests a need for a robust emergency preparedness plan that promotes resilience in health utilization during a global or local crisis for vulnerable populations.
ProQuest ID
Recommended Citation
Chrapah, Sandra Korkor, "Health Seeking Behaviors Of Pregnant And Post-Partum Women Living With Hiv In A Rural Region Of Kenya - A Mixed Method Study" (2024). All ETDs from UAB. 7640.
https://digitalcommons.library.uab.edu/etd-collection/7640
