Utilization of Free Maternity Services among Women of Child Bearing Age in Machakos County, Kenya

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Date
2021Author
Ngesa, Alice Mukunzu
Kirui, Joyce
Matheka, Isaac
Otieno, George
Yoos, Alison
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Introduction: globally, the rate of maternal
mortality is unacceptably high with Kenya
recording a rate of 362 maternal death per
100,000 live births. Even so, only 62% of women
deliver under skilled health care. The government
of Kenya introduced Free Maternity Services (FMS)
to all women delivering in public health facilities as
a way of increasing facility-based deliveries.
Despite this, intervention, health facility deliveries
in Machakos County are still low. This study aimed
to identify hindrances and enablers of the FMS
program in Machakos County. Methods: it was a
cross-sectional study conducted among postnatal
women who delivered between September 2018
and September 2019 in Machakos County. A total
of 394 women were enrolled. Data was collected
using questionnaires and focus group discussions.
Key informant interviews were conducted using
nursing officer in charge of selected health
facilities. Qualitative data was analyzed using chisquare and fishers exact. Multivariate logistic
regression was used to determine predictors of
utilization of FMS. Statistical significance was set
at p < 0.05. Results: utilization of FMS in Machakos
County was 75.6%. Factors that were associated
with utilization of FMS included marital status (p =
0.006), parity (p = 0.038), distance from health
facility (p = 0.000), services offered during labour
(p = 0.000), treatment of mothers by healthcare
workers during labour (p = 0.000), provision of
adequate food (p = 0.005), quality of service (p =
0.000) and cleanliness of the maternity ward (p =
0.000). Conclusion: utilization of FMS in Machakos
County is optimal. Health facilities should be
supported to offer FMS by providing them with
necessary supplies