Rights statement: 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
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Available under license: CC BY-NC-ND
Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Access and utilisation of reproductive, maternal, neonatal and child health services among women who inject drugs in coastal Kenya
T2 - findings from a qualitative study
AU - Ndimbii, James
AU - Ayon, Sylvia
AU - Abdulrahman, Taib
AU - Mahinda, Samantha
AU - Jeneby, Fatma
AU - Armstrong, Gregory
AU - Mburu, Gitau
N1 - 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
PY - 2018/12
Y1 - 2018/12
N2 - IntroductionThe 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.MethodsIn 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.ResultsWomen’ 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.ConclusionsSeveral 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.
AB - IntroductionThe 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.MethodsIn 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.ResultsWomen’ 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.ConclusionsSeveral 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.
KW - Reproductive, Maternal
KW - Child Health
KW - Harm reduction
KW - Integration, Africa
U2 - 10.1016/j.srhc.2018.10.002
DO - 10.1016/j.srhc.2018.10.002
M3 - Journal article
VL - 18
SP - 48
EP - 55
JO - Sexual and Reproductive Healthcare : Official Journal of the Swedish Association of Midwives
JF - Sexual and Reproductive Healthcare : Official Journal of the Swedish Association of Midwives
SN - 1877-5756
ER -