Maternal individual determinants of adverse maternal and neonatal outcomes among pastoralist women in Marsabit County, Kenya

Abstract

Adverse maternal and neonatal outcomes remain a major public health challenge globally, with Sub-Saharan Africa carrying a disproportionate burden. Pastoralist populations face additional barriers to care due to nomadic lifestyles, cultural practices, and limited access to health services, yet evidence on maternal-individual determinants in these settings remains limited. To examine maternal-individual determinants of adverse maternal and neonatal pregnancy outcomes among pastoralist women of reproductive age in Marsabit County, Kenya. A cross-sectional study was conducted among 422 women aged 15–49 years with documented pregnancy outcomes from four major hospitals in Marsabit County. Data were collected using a structured questionnaire and key informant interviews. Quantitative data were analyzed using SPSS v27, with chi-square tests and binary logistic regression performed to identify independent determinants. Qualitative data were coded thematically using NVivo. Results: Twenty-one percent of participants reported at least one adverse maternal or neonatal outcome, with low birth weight and preterm delivery accounting for 64.2% of cases. Significant determinants included planning for pregnancy (OR=0.309, p=0.044), birth preparedness (OR=0.445, p=0.008), early ANC initiation in the first trimester (OR=0.238, p=0.018), maternal age (OR=0.575, p<0.0001), and primiparity (OR=3.529, p<0.0001). The findings show that maternal-individual determinants strongly influence adverse pregnancy outcomes in pastoralist communities. Interventions promoting pregnancy planning, birth preparedness, and early ANC attendance, alongside adolescent pregnancy prevention and support for first-time mothers, are urgently needed.