Utilization of Free Maternity Services among women Aged 18-49 Years in Machakos County, Kenya
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Date
2021
Authors
Ngesa, Alice Mukunzu
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Globally, the rate of maternal mortality is unacceptably on the rise. Maternal mortality
rates in Kenya remain high at 362 per 100,000 live births. Only 62% of women
deliver under the care of a skilled provider indicating a deficiency in the quality of
care. The government of Kenya introduced the policy of Free Maternity Services to
all women attending public health facilities in June 2013 to increase skilled birth
attendance and reduce inequality by making services available to all pregnant women.
Despite the introduction and adoption of the free maternity policy in all government
facilities, there is still low utilization of the free maternity services by pregnant
women. The study sought to establish the determinants of utilization of free maternity
services among postnatal women in Machakos County. A cross sectional study was
carried out in Machakos County. A sample size of 421 postnatal women was
proportionally selected from each ward through systematic random sampling and
interviewed. The study mainly focused on the individual client characteristics, the
client related factors and organizational factors related to utilization of free maternity
services, which encompassed use of both quantitative and qualitative data collection
methods. Both quantitative and qualitative data was collected. Necessary approvals
were sought from relevant authorities and informed consent obtained from research
participants prior to data collection. Descriptive data was analyzed using Statistical
Package for Social Sciences version 25.0. Frequency distribution tables, graphs and
pie charts were used for data presentation. Qualitative data was presented as direct
quotes or narrations from respondents and triangulated with quantitative results.
Inferential statistics were calculated using Fischer’s exact tests and chi-square test
(p<0.05) done at 95% confidence interval to establish the association between study
variables. The study found out that the overall utilization level of free maternity
services by respondents was 75.6%. Chi-square test showed significant statistical
association between marital status (p=0.006), parity (p=0.038), distance from facility
and utilization of free maternity services (p=0.000), satisfaction with maternity
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), maternity services
offered were of high quality (p=0.000), maternity ward was not congested (p=0.009).
Fischer’s exact test showed significant statistical association between cleanliness of
the maternity ward (p=0.000), respect to clients by health workers (p=0.001)
availability of bed/linen (p=0.002), satisfaction with labour ward services during
delivery (p=0.000) with utilization of free maternity services. The study concludes
that the utilization of FMS was optimal, organizational factors were majorly
significantly associated with utilization of FMS.The study recommends that the
department of health to support health facilities to offer FMS by providing the
necessary supplies. These findings would assist key healthcare stakeholders to design
strategic policies and initiatives to ensure sustenance of Free Maternity Services in the
country. This would further ensure that the Free Maternity policy leads to improved
quality of maternal service provision in all public hospitals thus increased utilization
among women of reproductive age.
Description
A Research Project Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science in Public Health Systems Management and Application in the School of Public Health and Applied Human Sciences of Kenyatta University, June 2021
Keywords
Free Maternity Services, women, Aged 18-49 Years, Machakos County, Kenya