Causes of neonatal mortality two years before and after the implementation of a free maternal health care policy in Kenyan public health facilities

Abstract

Background: Neonatal mortality remains unacceptably high more so in the developing countries such as Kenya. The government of Kenya waived delivery fees charges in public health facilities through a free maternal health care policy on 1st June 2013 with an aim of reducing pregnancy related mortalities.

Objective: To determine the changes in causes of neonatal mortality following the implementation of a free maternal health care policy in Kenyan public health facilities.

Design: This study was of a quasi-experimental design to compare the causes of neonatal deaths two years before and after the exposure of new-borns to the free maternal health care services in Kenyan public health facilities.

Setting: This study was carried out in 77 public health facilities in Kenya.

Subjects: The study subjects for this study were 9,591deceased neonates.

Results: The highest proportion of neonatal deaths pre and post policy implementation were preterm delivery and low birth weight complications, birth asphyxia and trauma, neonatal infections and congenital anomalies.

Conclusion: There are no significant changes in the avoidable causes of neonatal deaths in Kenyan Public health facilities. With the policy addressing maternal health care financing, there is need to investigate the role of other health system blocks on neonatal deaths and address them to avert preventable causes of neonatal deaths.