Socio-Demographic Determinants of eCHIS Utilization for Maternal Health Services among Lactating Mothers in Muhoroni, Kisumu County, Kenya

Abstract

Introduction: Maternal mortality remains disproportionately high in sub-Saharan Africa. Kenya continues to face significant challenges in antenatal and postnatal care uptake. To address this, the Ministry of Health piloted the electronic Community Health Information System (eCHIS) in Muhoroni Sub-County. eCHIS supports community health service delivery through data collection, referral tracking and health education. However, limited evidence exists on how socio-demographic factors influence eCHIS utilization and maternal health service uptake. Aim: To determine the socio-demographic factors associated with eCHIS utilization in enhancing uptake of antenatal (ANC), skilled delivery and postnatal care (PNC) services. Methods: This study employed a cross-sectional descriptive design. A total of 398 lactating mothers with children under six months, whose pregnancies were registered in eCHIS and followed through to postnatal care, were included. Both purposive and simple random sampling techniques were applied, with participants first identified from the eCHIS registry and then randomly selected to form the final sample. Quantitative data were collected using structured electronic questionnaires and analyzed with SPSS v25. Regression analysis and structural equation modeling (SEM) were employed to assess associations between socio-demographic factors and uptake of ANC, skilled delivery and PNC services. Results: Education and age significantly influenced service uptake. Higher education was associated with increased antenatal, skilled delivery, and postnatal care utilization (P=0.010). Age was significant (P=0.003); adolescent (15–19) and older mothers (35–49) recorded reduced uptake compared to women aged 20–34. Marital status was not statistically significant (P=0.110). SEM showed socio-demographic factors predicted eCHIS utilization (β=0.273, p<0.01), which mediated their effect on maternal health service uptake. R² values indicated moderate explanatory power (41.2% variance explained for eCHIS utilization; 42.8% for service uptake). Conclusion: Socio-demographic factors, particularly education and age, influence ANC, Skilled delivery and PNC service uptake through eCHIS. Tailoring digital health interventions to these profiles, strengthening maternal health literacy, and implementing age-sensitive outreach are essential to maximize eCHIS impact and improve maternal outcomes in resource-limited settings. These findings inform the development of evidence-based digital health policies that promote equitable maternal health service delivery.