Impact of health sector services fund on the quality of maternity services at health centres in Kisii South Sub-County

Abstract

Background: The Ministry of Health used to disburse funds to the sub-counties through the sub-county treasury. However, there were operational difficulties and challenges for the health facilities in accessing these funds. It is against this background that the Ministry of Health came up with a more innovative approach in 2005 in which funds are credited directly into health facility accounts thereby bypassing the sub-county treasury. The direct funding innovation was first piloted in the Coast Province in 2005 and in 2010 it was rolled to the rest of the country. Since then no further evaluation has been carried out to assess the impact of this funding scheme in other sub counties.

Objectives: To assess the impact of the direct funding on the quality of deliveries in maternity units of health centres in Kisii South Sub-county.

Design: Descriptive study.

Setting: The three health centres in Kisii South Sub-county namely, Nyamagundo, Riana and Riotanchi.

Subjects: Secondary data from the maternity registers and interviewing staff working in maternity units.

Results:There was statistically significant (p=0.05) increase in the number of deliveries in all the three health centres with Nyamagundo having 131%, Riana 114% and Riotanchi 103%, 33% of the facilities were conducting outreach services and purchasing medical supplies. However, the medical supplies and staffing challenges were still there in all and the structural barriers to quality maternity services were identified in all the facilities.

Conclusions: The recommendations are that the funding should be enhanced and it should be workload or output based as the challenges vary among the facilities and other service delivery indicators should also be evaluated, besides rolling it to the other sub-counties in the same category.