Sociodemographic, Economic, and Household Characteristics and Access to Healthcare for Pregnant Women and Children Under Five During COVID-19 in Karemo and Manyatta, Kenya Restricted; Files Only

Abstract

Background: Kenya was the first country in East Africa to report a confirmed COVID-19 case in March 2020. The Kenyan government enforced many measures to control the spread of the virus. Prior research found evidence of deficient access to healthcare for children during the pandemic in Kenya. Some research found low access to healthcare for pregnant women; however, some found no evidence of a change during the pandemic in Kenya.

 

Objective: In this study, I measured the prevalence of not accessing healthcare for pregnant women and children under five in Manyatta and Karemo, Western Kenya, during the COVID-19 pandemic. I examined whether not accessing healthcare was associated with households' demographic and social characteristics.

 

Methods: I used census data from two HDSS catchment areas in Western Kenya for this cross-sectional study. The data had 28,031 household observations; there were 4,199 households with pregnant women and 12,249 households with children under five. I employed descriptive analysis to explore the prevalence of not accessing healthcare. I used adjusted logistic regression to evaluate associations between socioeconomic and household characteristics and not accessing healthcare for pregnant women and children under five. All analyses were performed using SAS 9.4.

 

Results: Only 2.2% of households reported not accessing healthcare for pregnant women. Meanwhile, 42.9% of households said their children under five did not access healthcare during the pandemic. The lack of access to healthcare for pregnant women and children was more prevalent among rural households and households headed by uneducated persons. The lack of access to healthcare for pregnant women was significantly higher among households that experienced income disruption. Children under five in households headed by females had higher odds of lack of healthcare access.

 

Conclusion: The study found a low prevalence of lack of access to healthcare for pregnant women during the pandemic (2.2%), whereas the delay in accessing healthcare for children under five was high (42.9%). Not accessing healthcare for pregnant women and children during COVID-19 in Kenya was higher in rural households and households with less advantageous socioeconomic status.

 

Table of Contents

1         INTRODUCTION  1

1.1      Objectives And Research Questions 2

2         LITERATURE REVIEW   3

2.1      Access To Healthcare And Its Impact On Health 4

2.2      Maternal Health In Kenya 6

2.3      Children’s Health In Kenya 8

2.4      COVID-19 In Kenya And Government Measures 9

2.5      Access To Antenatal Care During COVID-19 In Kenya: 10

2.6      Access To Children’s Healthcare During COVID-19 In Kenya 12

2.7      Access to HIV During COVID-19 14

2.8      COVID-19 and Its Effect on the Economy and Other Indirect Effect On Household Hardship In Kenya 15

2.9      Conceptual Framework 16

2.9.1   Study Significance 16

2.9.2   Factors associated with lack of accessing healthcare during COVID in Kenya 16

2.9.3   Study variables 19

3         DATA AND METHODS 20

3.1      Study population 20

3.2      DATA SOURCE  21

3.2.1   Specific Indicators: 23

3.3      DATA WORK  23

3.3.1   Dependent Variables 24

3.3.2   Right-hand sided Variables 24

3.3.3   Data Analysis 26

3.4      Ethical Consideration: 27

4         RESULTS 27

4.1.1   Descriptive Statistics 27

4.1.2   Bivariate and Multivariate Analysis for Households characteristics and not accessing healthcare for pregnant women 28

4.2      Access to Healthcare for Children Under Five 30

4.2.1   Descriptive Statistics 30

4.2.2   Bivariate and Multivariate Analysis For Households Characteristics and not accessing healthcare for Children under five 31

5         Discussion 33

5.1      Strength and Limitations 38

5.2      Recommendations 40

5.3      Conclusion 41

6         REFERENCES 1

7         TABLES AND FIGURES 1

Table 1: Description of households with Pregnant women (n=4199) 1

Table 2 Association between households sociodemographics, economic hardship, and not accessing healthcare for pregnant women (n= 4199) 3

Table 3: Description of households with children under 5 (n= 12249) 5

Table 4: Association between households sociodemographic, economic hardship and not accessing healthcare for Children under five during COVID-19 (n=12249) 7

Figure 1. The conceptual framework for accessing healthcare for pregnant women during COVID-19 9

Figure 2. The conceptual framework for accessing healthcare for children DURING COVID-19 11

Figure 4. Households with pregnant women who accessed healthcare and households with pregnant women who did not access healthcare 11

Figure 5. Households with children who accessed healthcare and households with children who did not access healthcare 12

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Sub Saharan Africa Studies Health Sciences, Public Health
Stichwort	Children under five Kenya Pregnant women COVID-19 Access to healthcare
Committee Chair / Thesis Advisor	Solveig Argeseanu Cunningham, Emory University
Committee Members	Jonathan Muir, Emory University David Obor, Kenya Medical Research Institute, Centre for Global Health Protection
Partnering Agencies	International governmental organization (e.g., Agency for International Development, etc.)

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