Determinants of Choice for Delivery Place among Mothers in Selected Sub-Counties, Mombasa County

Abstract

This study aimed to identify the socio-cultural and economic factors influencing mothers' choice of delivery place in selected sub-counties of Mombasa County. A cross-sectional research design was used, targeting 297 mothers who delivered within the past 2 years and lived in Kisauni and Nyali Sub-Counties, using stratified and simple random sampling. The questionnaire was the only data-collection tool, and the study used descriptive and inferential analyses in SPSS. The study found that socio-cultural factors strongly determined delivery place. Mothers whose decisions were not determined by socio-cultural factors were 6.36 times more likely to give birth at health facilities, even after accounting for economic factors and access to health facilities. This finding reveals that financial capacity is a key determinant of access and utilization of prenatal, antenatal and postnatal health care.  Additionally, mothers’ decisions were influenced by indirect costs, including required delivery supplies, transportation, opportunity costs, and informal payments. Socio-cultural factors, namely family influence, cultural norms, and community expectations, strongly influenced the place of delivery even when accessible and affordable healthcare services were available. Economic factors, particularly household income and indirect costs, influenced mothers' choice of place of delivery. Cultural norms and economic constraints also drove home delivery. To address indirect costs associated with hospital deliveries, implement interventions that reduce hidden fees, provide transport vouchers, and run campaigns to increase awareness of the benefits of, access to, and use of programs like Linda Mama/SHA.