Perinatal Outcomes of Free Maternity Services in Mama Lucy Kibaki Hospital, Nairobi County, Kenya
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The introduction of free maternity services in all public healthcare facilities in Kenya was the government’s initiative to decrease maternal morbidity and mortality and promote sustainable health for both the mother and infant. It has been a major step in the achievement of vision 2030 that aims at ensuring women from resource poor settings have access to maternal care. Objectives of the study included a comparison of the perinatal outcomes before and after implementation of the free maternity services, determine both health facility and staff factors contributing to perinatal outcomes and also determine the maternal characteristics of women seeking free delivery services at MLKH. There is evidence of stagnation in addressing perinatal health in Kenya. The study adopted a cross-sectional descriptive survey design involving all women seeking free delivery services at Mama Lucy Kibaki hospital. Data was collected using both open-ended and closed-ended questions. Questionnaires were researcher administered where face-to-face standardized interviews with the respondents was conducted. Pretesting was done to ensure that the research tools tested what they intended to (validity) and that they consistently measure the variables in the study (reliability). Data was analyzed using SPSS software version 20. Chi-square test was used to test for the association between independent and dependent variables. The average monthly patient delivering at Mama Lucy Kibaki hospital at the time of the study was 630.From this population a study sample of 228 participants was obtained calculated using Fishers formulae 2003 and sample adjusted using Cochrans formulae (1977).23 nurses(10%) of the study population were also interviewed to represent the key informants. Simple random sampling was used to get the study participants and convenient sampling used for the key informants. Data obtained from the study participants was analyzed, and the summary was written for the necessary explanation. The study findings showed that there was an increase in the number of women seeking FMS, and resultant increase in the number of good perinatal outcomes as well as a decrease in the number of poor perinatal outcomes. Further, the study showed that despite the FMS 60.2% of the mothers sought ANC services in the second semester with the majority not meeting the WHO recommended ANC visits. The study also showed that 88.5% of the women did not suffer any disease in pregnancy. 65.4% of the diseases suffered was anaemia with 80% of those who suffered being primigravidae. A correlation between the number of ANC visits and the perinatal outcomes was significant (x2-8.125, df-3, P=0.003). The trimester of ANC booking was also significant (x2=3.615, df-2, P=0.001). Despite the increased work load, the number of nurse’s supplies and equipment remained constant. The supplies and equipment’s inadequacy was reported by 100% of the key informants, while 87%.of the study respondents perceived that the supplies and equipment’s were inadequate. The study concluded that FMS has contributed to improved perinatal outcome and it recommended that pregnant women be sensitized on the importance of seeking ANC services immediately they are diagnosed pregnant, and further that the county government of Nairobi should boost the hospitals with supplies, equipment and human resource specifically nurses, so as to cope with the increased workload.