Devolution of Healthcare and Access to Maternal Healthcare Services in Mandera County, Kenya
Hassan, Adan Hussein
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Maternal healthcare is paramount to both the child and the mother. However, there has been cases of increased maternal deaths in Kenya. When women receive timely care from skilled providers with modern facilities, the causes of maternal deaths can be controlled. These calls for increased budget allocation to health facilities to address maternal deaths affect not only families, but also the country's economic development. The objectives of the study were; to establish the effect of health staff placement on access to maternal healthcare services in Mandera county, Kenya, to determine effect of access to specialized treatment, to evaluate the effect of cost of healthcare on access to maternal healthcare services in Mandera county, Kenya, to assess the effect of health budgetary allocation on access to maternal healthcare services in Mandera county, Kenya and to investigate the effect of infrastructure on access to maternal healthcare services in Mandera county, Kenya. The study utilised Donabedian Quality of Care Theory and System Thinking Approach Theory. Descriptive research design was used. Target population was 1007 health officers in Health care sector in Mandera County. The sample was 286 employees. Questionnaire was the main tool for collecting data. Pilot was done in the purposely selected public health facilities in Mandera county. The sample used in the pilot was not be included in the main study. Data was analysed through the use of quantitative and qualitative analysis method. Data was presented in tables and figures. Ethical issues such as anonymity, confidentiality and informed consent were considered. The result was that healthcare policies which provides guidelines to achieve a considerable improvement in Mandera county's overall health situation were in place. It was clear that the county lacked access to numerous specialist treatments. This was ascribed to inadequate equipment that made it difficult to offer healthcare to the populace. In order to provide access to specialized treatment and achieve its policy objectives while minimizing inequities, the Mandera County Government increased the number of referral hospitals from two to sixteen. In order to achieve its policy objectives and remove inequities, the Mandera County Government raised healthcare spending with an average yearly budgetary allocation of KSh2.4 billion, which is comparable to a 600% increase before devolution. The story before devolution was one of high mother and infant mortality, low child survival, and an above-average sickness burden. The state of health services is poor due to a lack of basic healthcare facilities in compared to the tiny nomadic population, as well as a lack of infrastructure, pharmaceutical supplies, and access to healthcare. In comparison to other counties around the nation, Mandera county has not used the maternity care package as extensively. According to the study's findings, access to maternal healthcare services in Kenya's Mandera county has significantly improved as a result of the devolution of healthcare policy. The study's findings suggest that county and federal governments should cooperate and combine their resources to improve the devolved health systems and improve maternity healthcare. The research suggests doing a comparable investigation on the impact of maternal health service devolution, which should include speaking with county government representatives and Kenyans who utilize the services of public hospitals.