Factors that influence healthcare service utilization during COVID-19 pandemic among pregnant women and caregivers with children under two years in Rongo sub-county, Migori County, Kenya

Abstract

Background: Health systems have failed in past epidemics to maintain delivery of routine health essential services. Most resources including human and essential supplies are all diverted to address health emergency, sometimes resulting in lack of important basic and routine health services. Methods: This was a retrospective cross-sectional study with mixed data collection methods, where respondents were asked questions on how COVID-19 affected them with regard to utilization of MCH healthcare during the first peak of the COVID-19 in Kenya. Two high volume facilities were selected purposively based on volume and capacity of services offered. A random sample was drawn from the stratum using a list generated by community health workers (CHWs) attached to the health facilities. Key informant interviews were used to collect data among health care providers and structured questionnaire was used for pregnant women and caregivers. Independent variables, social distancing, social stigma, communication and human mobility restriction were associated with health care service utilization and significant at 0.05 p value. Results: Correlation analysis indicated social stigma (r-0.407, p<0.512), social distancing (r-0.324, p<0.001) and human mobility restrictions (r-0.606, p<0.001) negatively influenced service utilization. Whereas COVID-19 related communication (0.631, p<0.001) was protective and thus promoted service utilization. The hierarchical linear regression model explained 67.73% of the total variations in the health care service utilization, which was r=0.6773. Conclusions: From the findings social stigma, communication, social distancing and human mobility restrictions influence health care service utilization. Ministry of health should strengthen targeted community outreaches for pregnant women and caregivers with children under two years.