Kenya’s maternal mortality ratio remains high. A key intervention in reducing maternal mortality is
increased use of skilled delivery care services. While good progress has been made in promoting
skilled delivery care services in Kenya, a huge gap in utilization remain between urban and rural
areas. This study sought to quantify the urban -rural gap in utilization of skilled delivery care services
and identify the determinants of this gap. Data used was drawn from the 2014 Kenya Demographic
and Health Survey. First, a probit model of determinants of skilled delivery care services was
estimated for the full sample, rural sample and urban sample. The results indicated that education,
wealth, use of antenatal care services and age of the woman were some of the factors associated with
increased probability of using skilled delivery care services. Secondly, Fairlie decomposition
technique was used to quantify differences in predicted probability of use of skilled delivery care
services between rural and urban areas and to identify individual characteristics that contribute to this
gap. Rural utilization probability was estimated at 53% and urban probability at 81%, a gap of 28%.
Differences in education, wealth and use of antenatal care services between urban and rural areas
explained 71% of this gap. Policies that promote secondary and tertiary education, increased use of
antenatal care services and economic empowerment of rural women should be promoted to reduce
urban- rural gap in utilization of skilled delivery care services.