Perceived Factors Influencing Performance of Maternal and Child Health Programs in Urban Informal Settlements in Kenya: a Case of the Government’s Maternal and Child Health Program in Dagoretti Subcounty, Nairobi

Abstract

This study sought to understand how various perceived factors influence the performance of Maternal and Child Health Program. The researcher has vast experience in working in programs around children aged 0-5 years. This experience informed the choice of factors to settle for. These factors are; access to appropriate health services, personal characteristics of clients, availability of equipment in Mother and Child Health department in the facilities and COVID-19 mitigation protocols (as these have tremendously influenced the performance in MCHP over the last two years). This research project sought to establish the influence of these factors on performance of MCHP in terms of how services are offered and sort-for in health centers and in the community level. The Sub- County made significant progress in maternal and child health in the past years, through the support of the Ministry of Health and other stakeholders like non-governmental organizations (UNICEF, Concern Worldwide, Linda mama, Child Fund, feed the children, save the children, HOPE international, Afya jijini by USAID, just to mention a few). The research design for the study was survey design. The design employed aspects of both qualitative and quantitative research designs. The researcher intended to get detailed information by using survey through; using both open-ended and closed-ended questionnaires, conducting caregiver interviews (for female caregivers), and Key Informant Interviews (Nurses in the MCH Clinics, Community Health Workers, Community health Assistants). It is a sequential mixed methods study. In this study, there was need to first carry out a rapid telephone survey of households with expectant mothers and caregivers of children between 0-5 years living in these urban informal settlements. Based on the results of the rapid telephone survey, an in-depth qualitative interview (n=7) was carried out. Descriptive statistics that were used for preliminary analysis were; frequencies, means and standard deviations. For qualitative analysis, audio-recorded interviews were transcribed verbatim and content translated into English. After in-depth reading and reflection of the scripts, coding was done. Framework and content analysis was used to analyze qualitative data. Conclusions were; access to healthcare services positively affects the performance of MCHP, there was no significant influence of personal characteristics of clients to performance of MCHP, availability of equipment in the health facilities positively influences the performance or MCHP and, COVID-19 mitigation protocols negatively influenced the performance of MCHP.