Mothers’ knowledge, attitude and self efficacy of clean home birthing practices in a rural community of Kenya

Julius K. Mwangi, Anne M. Pertet


Background: In Kenya, approximately 38% of the children are delivered at home. Thus, hygienic practices during home birthing are essential in the prevention of infections to the mother and baby as well as prevention of neonatal deaths. The purpose of our study was to establish mothers’ knowledge, attitude and self-efficacy of clean birthing which would help her influence the behaviour of those assisting her during child birth. We used a correlational, cross-sectional design to examine the relationships knowledge, attitude, and self-efficacy and clean birthing practices.

Methods: We collected data using a structured questionnaire through face to face interviews in Olkalou sub-county, Nyandarua County, Kenya. They consisted of 374 mothers of reproductive who had delivered at home six months before the start of the study. Multi-stage sampling technique was used to select the study sample. Likert scale was used to assess attitude and self-efficacy.

Results: Close to 2/3rd of the babies were delivered at home by friends, relatives, traditional birth attendants (TBAs) or self-delivered. Cleanliness during home birthing was sub-optimal. Clean home birthing was associated with mothers’ knowledge (odds ratio=1.70) and marital status (OR=2.9).

Conclusions: Despite the advocacy on skilled birth attendants, women continue to deliver at home, thus the need to empower mothers with knowledge, positive attitudes and self-efficacy on clean home birthing to reduce infections during childbirth.


Clean home delivery, Home birth, Skilled birth attendant, Attitude, Self-efficacy, Perceptions, Knowledge, Marital status

Full Text:



UNICEF. The State of the World’s Children 2014; 2014. Available at: /numbers/documents/english/SOWC2014%7B_%7DIn%5CnNumbers%7B_%7D28%5CnJan.pdf. Accessed on 3 January 2018.

KDHS. Kenya 2014 Demographic and Health Survey.

WHO World Health Organization, Cooper P, Johnson R, et al. Managing newborn problems: a guide for doctors, nurses and midwives. WHO Libr Cat Data. 2003: 338.

Blencowe H, Cousens S, Mullany LC, Lee AC, Kerber K, Wall S, et al. Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: A systematic review and Delphi estimation of mortality effect. BMC Public Health. 2011;11(3):11.

Saaka M, Iddrisu M. Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana. Int J Popul Res. 2014;2014:1-10.

Penfold S, Hill Z, Mrisho M, Manzi F, Tanner M, Mshinda H, et al. A large cross-sectional community-based study of newborn care practices in Southern Tanzania. PLoS One. 2010;5(12):e15593.

Hill Z, Tawiah-Agyemang C, Okeyere E, Manu A, Fenty J, Kirkwood B. Improving hygiene in home deliveries in rural Ghana: How to build on current attitudes and practices. Pediatr Infect Dis J. 2010;29(11):1004-8.

Adelaja LM. A Survey of Home Delivery and Newborn Care Practices among Women in a Suburban Area of Western Nigeria. ISRN Obstet Gynecol. 2011;2011:1-9.

Waiswa P, Peterson S, Tomson G, Pariyo GW. Poor newborn care practices - a population based survey in eastern Uganda. BMC Pregnancy Childbirth. 2010;10:9.

Mrisho M, Schellenberg JA, Mushi AK, et al. Understanding home-based neonatal care practice in rural southern Tanzania. Trans R Soc Trop Med Hyg. 2008;102(7):669-78.

Shamba DD, Schellenberg J, Penfold SC, et al. Clean home-delivery in rural southern tanzania: Barriers, influencers, and facilitators. J Heal Popul Nutr. 2013;31(1):110-117.

Tann CJ, Kizza M, Morison L, et al. Use of antenatal services and delivery care in Entebbe, Uganda: A community survey. BMC Pregnancy Childbirth. 2007;7.

Bream KDW, Gennaro S, Kafulafula U, Mbweza E, Hehir D. Barriers to and facilitators for newborn resuscitation in Malawi, Africa. J Midwifery Women’s Heal. 2005;50(4):329-34.

Republic of Kenya Nyandarua County Integrated Development Plan. 2013.