| This is a study of health-seeking behavior of pregnant Muslim women in Mombasa, Kenya. Early initiation and attendance of prenatal care has been shown to result in positive pregnancy outcomes. In addition, birth delivery assistance from a trained and well-equipped provider is necessary to reduce maternal morbidity and mortality.;Kenya, among other countries in Africa has a high maternal mortality rate. The major direct causes of mortality are hemorrhage, sepsis and hypertensive diseases of pregnancy. Malaria, anemia, tuberculosis and HIV/AIDS as well weaken the immune system and add to the toll of death during childbirth. Due to the HIV/AIDS epidemic, Mombasa has an increasing rate of mother-to-child transmission (MTCT). In this study, women's knowledge of MTCT is assessed.;To address these above issues, Kenya developed a Safe Motherhood Initiative in 1987. This initiative was to identify poverty reduction strategies among women, improve reproductive health and assure child survival. The research reported here adds to the studies of the Safe Motherhood Initiative from the women's perspective. I believe that many of the findings of the research reported here can apply to urban areas across Kenya and, indeed elsewhere in urban Africa where medical pluralism is the norm.;I investigated the available maternal health care services and how, when and why women used or did not use them. I used participant observation followed by and a questionnaire to collect data from 265 Muslim women. Logistic regression techniques are used to estimate models of prenatal care use and choice of a birthing facility. Women were interviewed during the postpartum period, while in the hospital, at home and while attending the sixth week check-up. The results demonstrate the complexities of women's lives and the difficulties they face in accessing maternity health care. Their reasons for not getting the care they need include cost, distance, lack of competence of health care providers, and frequent shortages of essential equipment and supplies to provide basic essential obstetrical care. In addition, their beliefs, knowledge and attitudes about the efficacy of health care services and the curability of their condition affect their health-seeking behavior. |
