Uptake of Maternal, Neoanatal and Child Health Services Provided under Universal Health Coverage in Machakos County, Kenya
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Date
2024-04
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Kenyatta University
Abstract
Universal health coverage (UHC) offers an essential package of health services to a wide range of people while protecting citizens financially in case of an illness. UHC is given a high priority globally by the UN sustainable development goal (SDG) as a health-related aim. Hence, the national health system of Kenya prioritized UHC. The WHO has been monitoring of UHC progress through follow up of four MNCH (Maternal, Neonatal, Child Health) indicators; Antenatal care, skilled deliveries, immunization and family planning. MNCH services have received a lot of investment over the years but still women and children are dying. MNCH services are part of essential services in Kenya. This study aimed at assessing the uptake of universal health coverage provided MNCH services along with factors affecting the uptake. This has remained undocumented since the initiation of UHC pilot study in December 2018 in Kenya’s Machakos County. A descriptive cross-sectional study design was used with a sample size of 422 respondents. This study was undertaken in Machakos Sub-County, focusing on women of reproductive age (WRA). A researcher administered questionnaire, interviews and focused group discussions were adopted for data collection. SPSS version 26 application was used to analyse data. Both descriptive and inferential statistics were deployed in the analysis. Overall, first level analysis showed that there was a significant association between demographic factors at (.05), χ² (9, N = 145) = 27.118, P <.001, supply side factors significance at (.05), χ² (13, N = 145) = 21.872, P <.001, patient related factors at (.05), χ² (9, N = 145) = 24.553, P <.001and level of uptake of MNCH services. Further a second level analysis divulged that, time taken to reach facility (OR 12.26; 95% CI 1.07 to 140.48) and a perception that a CHV could attend to them during an emergency (OR 4.14; 95% CI 1.23 to 13.91) were significant patient related factors. Supply side factors found to be significant were visit from a CHV (OR 125.93; 95% CI 18.37 to 863.27), a perception that services were of quality (OR 684.411; 95% CI 50.65 to 9248.93, adequacy of staff (OR 1.00; 95% CI 1.0004 to 0.021 and adequacy of hospital commodities (OR 19.83; 95% CI 1.67 to 235.93). The study recommends that the National and county governments should conduct social mobilization to increase FP uptake, make increasing CHV coverage a priority, conduct community action to increase insurance coverage. In addition, the County government should conduct customer care trainings on their staff. Similarly, it would be progressive for national government to develop a UHC policy that puts into consideration both supply side and patient related factors.
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) In the School Health Sciences of Kenyatta University, April 2024.
Supervisors
1. John Paul Oyore
2. Isaac Mwanzo