Access and utilisation of reproductive, maternal, neonatal and child health services among women who inject drugs in coastal Kenya:findings from a qualitative study

Ndimbii, James and Ayon, Sylvia and Abdulrahman, Taib and Mahinda, Samantha and Jeneby, Fatma and Armstrong, Gregory and Mburu, Gitau (2018) Access and utilisation of reproductive, maternal, neonatal and child health services among women who inject drugs in coastal Kenya:findings from a qualitative study. Sexual and Reproductive Healthcare : Official Journal of the Swedish Association of Midwives, 18. pp. 48-55. ISSN 1877-5756

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Abstract

Introduction The Kenyan government has committed to increasing access to comprehensive reproductive, maternal, neonatal and child health (RMNCH) services. However, inequalities still exist. Women who inject drugs are an important sub-population for public health interventions, yet their RMNCH needs have largely been overlooked. Additionally, there is a lack of research to inform RMNCH interventions for this sub-population. Methods In 2015, we undertook interviews and focus group discussions with 45 women who inject drugs and five key stakeholders to understand these women’s RMNCH experiences and needs. Results Women’ access to essential services across the RMNCH continuum was low. Two thirds of the women were not using contraception. Many discovered they were pregnant late, due to amenorrhea of drug use, and thus were unable to enroll for antenatal care early. Facility-based deliveries were limited with many choosing to deliver at home. Following delivery, women’s attendance to immunization services was sub-optimal. Stigma from healthcare workers was a major factor impeding women’s use of existing RMNCH services. The prospect of experiencing withdrawals at health facilities where waiting times were long, deterred utilization of these services. Additionally, women faced competing priorities, having to choose between purchasing heroin or spending their money on health-related costs. Conclusions Several barriers disrupted women’s access to services across the RMNCH continuum. Consequently, there is a need to develop equitable, comprehensive, and family-centered RMNCH interventions tailored to women who inject drugs, through a combination of supply- and demand-side interventions. For optimal impact, RMNCH services should be integrated into harm reduction programs.

Item Type:
Journal Article
Journal or Publication Title:
Sexual and Reproductive Healthcare : Official Journal of the Swedish Association of Midwives
Additional Information:
This is the author’s version of a work that was accepted for publication in Sexual & Reproductive Healthcare. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Sexual & Reproductive Healthcare, 18, 2018 DOI: 10.1016/j.srhc.2018.10.002
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2900/2913
Subjects:
ID Code:
128129
Deposited By:
Deposited On:
11 Oct 2018 14:22
Refereed?:
Yes
Published?:
Published
Last Modified:
27 Sep 2020 04:50