PORTABLE OBSTETRIC ULTRASOUND SERVICES AND MATERNAL HEALTH OUTCOMES AMONG RURAL WOMEN ATTENDING MALINDI SUB-COUNTY HOSPITAL, KILIFI COUNTY, KENYA

Abstract

Maternal mortality remains a major development challenge in rural areas, where limited access to quality maternal healthcare and diagnostic services persists. Portable obstetric ultrasound can improve access by bringing essential diagnostics closer to underserved women. The study examined the relationship between portable obstetric ultrasound services and maternal health outcomes among rural women attending Malindi Sub-County Hospital, Kilifi County, Kenya. Specifically, the study assessed the influence of accessibility, quality of imaging and diagnosis, cost, and usability of portable obstetric ultrasound services on maternal health outcomes. The study was informed by Health Belief Model and Diffusion of Innovation Theory. A convergent parallel mixed-methods research design was adopted. Target population was 5,065 participants, from which a sample of 371 pregnant women was determined using Yamane’s formula. Additionally, 10 healthcare providers and 15 community health promoters were purposively selected for qualitative inquiry. Data were collected using questionnaires and interview guides, with the instruments pilot-tested for reliability and validity. Quantitative data were analyzed using SPSS Version 27, while qualitative data were analyzed thematically. The findings revealed significant positive relationships between all four dimensions of portable obstetric ultrasound services and maternal health outcomes. Quality of imaging and diagnosis had the strongest correlation with maternal health outcomes (r = 0.768), followed by usability (r = 0.739), accessibility (r =0.701), and cost (r = 0.583). Multiple linear regression showed that the model was statistically significant, F (4, 360) = 243.781, explaining 72.9% of the variation in maternal health outcomes (R² = 0.729). Quality of imaging and diagnosis was the strongest predictor (β = 0.369), followed by usability (β = 0.318), accessibility (β = 0.261), and cost (β = 0.143), all at p < 0. 001.The study concludes that strengthening portable obstetric ultrasound services can improve maternal health outcomes, promote equitable access, and strengthen rural maternal healthcare delivery.