Utilization of Maternal Health Care Services Offered at the Facility in Nairobi County: a Case Study of Public Health Facilities Performance

Abstract

Approximately 585,000 women in their reproductive age encounter death every year due to pregnancy related causes all over the world according to the World Health Organization (WHO). According to the 2014 Kenya Demographic Health Survey, the MMR was 362 maternal deaths per every 100,000 live births and the infant mortality rate was 39 deaths per every 1,000 live births in 2014. The access to and availability of maternal health care services has been of great importance to achieving SDG 3 which aimed at reducing maternal deaths to below 70 per 100 000 births as well as ending deaths that can be prevented in newborns and children under the age of 5 years, where all countries aiming to reduce infant deaths to at least as low as 12 per 1000 births as well as deaths of children under the age of 5 to at least as low as 25 per 1000 births. (World Health statistics, 2017) This remains a huge task and has not yet been achieved since the risk of maternal and infant death is still high (Girmaye et al, 2016). This study sought to establish the level of utilization of maternal health care services in Nairobi County after the launch of the free maternity policy and Beyond Zero clinics. The study utilized data from the DHIS2 for the period 2012-2015 for pregnant women and deliveries conducted within the period, i.e. two years preceding the launch of free maternity services and two years after the launch of free maternity services. This data was supplemented with key informant interviews that targeted health facility in-charges. The findings of the study show that there was an increase in women who sought ANC services however in the health facilities selected as high volume and offering all maternal health care services. Women attending at least four ANC visits also increased in the period of the year 2014 and 2015 owing to the launch of the free maternity services and Beyond Zero Campaign. This study showed an existent of a relationship in pregnant women‟s awareness level and the ability to consider and take up maternal healthcare services. Their level of awareness was viewed significant factor that determined their resolve to go and deliver their babies in a health facilities. There was an increase in uptake of facility deliveries with majority of the women in the selected health facilities choosing to deliver from level four facilities as compared to level 3 facilities. Coming from the challenges the country has had in addressing both maternal and infant mortalities, more needs to be done in order to empower the public and the community at large with information on the importance of accessing maternal health care services from a qualified health care provider. Efforts should be channeled to encourage a health seeking behavior and enhance uptake of maternal health care services by pregnant women. Further research should be done focusing on the effectiveness of the two interventions (free maternity and beyond zero clinic) in the utilization of maternal health care services in Kenya.