Factors associated with uptake of free maternity services at Kabarnet County Hospital

Abstract

Introduction: High maternal mortality is a global issue now apparent with unattained Millennium Development Goal five. World Health Organization 2015, reported developing countries especially those in sub-Saharan Africa as most affected with a Maternal Mortality Rate of 546 while Kenya at 510 was among those highlighted. A skilled assisted delivery is known to reduce maternal mortality hence the Government of Kenya implemented free maternity services in June 2013 to remove financial barriers to it. The study sought to determine factors associated with uptake of free maternity services.

Methodology: It was a cross sectional study, conducted at Kabarnet County Hospital among women attending maternal child health clinic who had a birth three years prior to study. A sample size of 379 was obtained using Cochran’s formula and systematic sampling was applied. Ethical consideration was obtained from Kenyatta National Hospital/ University of Nairobi ethical review committee. Data was collected through structured questionnaires and analyzed using binary logistic regression.

Findings: Majority of participants exemplified socio demographic factors identified from previous studies to promote skilled assisted deliveries. Of the 379 women interviewed; 70.4% were between 21 to 30 years, about three quarter (75.7%) had education beyond primary school, 89.7% lived within 7km from government maternity facility and 89.4 % had a birth plan. Most of the deliveries (95.8%)  ook place at government hospitals while 3.2% were in private hospitals and 0.5% away from hospital. Three quarter of participants
stated good services as their reason for choosing place of delivery. Presence of modern equipment/technology and referrals were  significantly associated with hospital deliveries with 0.001 and 0.016 p values respectively

Conclusion: Well-equipped and functional maternity facilities, if made accessible, affordable and acceptable will promote skilled assisted deliveries.

Key words: Maternal Mortality Rate, Skilled Assisted Deliveries, Free Maternity Services