Influence of Socio-economic Factors on the Access to Free Maternal Healthcare Program Services in Embu East Sub-county, Kenya

Abstract

Maternal health1care services are health services provided to mothers of reproductive ages and their children. Over the past ten years, the interest in maternal1health1care services has been increasing across the globe. Despite the initiatives and policies created by the government1and other1stakeholders to provide free maternal health care program services, access to maternal health care remains an issue in most African countries, including Kenya. The objective was to determine the socio-economic1factors influencing access to free maternal1health care program services in Embu East sub-county, Kenya. The specific objectives focused on how; distance to health facilities, quality of service, household characteristics, and individual attributes influence access to maternal health care program services. A descriptive1survey research1design was adopted. Quantitative1and qualitative data were collected using a standardized questionnaire and an interview schedule, respectively. The study's target population was 17,528 women aged 18-49 years seeking free maternity healthcare services in level 4 hospitals. The sample1size formula used in this study was1Yamane's formula, which resulted in a sample1size1of 391 respondents being chosen using stratified random selection techniques. In addition, medical personnel providing maternal health care services in the Runyenjes Level 4 and Kianjokoma Level 4 hospitals were purposively selected during the study and interviewed. The1researcher tested the validity and reliability of the research tools in a pilot study with 39 randomly selected respondents. Validity was assessed using content, face, and construct validity, whilst reliability was assessed using Cronbach's alpha1coefficient. To evaluate quantitative data, the researcher used descriptive1statistics. Frequencies, 1means, and1standard1deviations were used in descriptive statistics. Regression analysis was used to estimate the relationship between the variables. Thematic1analysis was1used to evaluate qualitative data. The1study findings1 showed1that the distance1to the health facility, the quality of service, the household characteristics and the individual attributes influence access to free1maternal healthcare program services. The researcher recommends that the Ministry of health collaborate at the national1and county levels to provide more health facilities nearer to the people. The management of the1health facilities should ensure that maternal1health care seekers1are kept for long, considering the sensitivity of the service. In addition, the introduction or strengthening of existing sensitization and economic empowerment programs for women to ensure that they can make informed healthcare decisions are recommended by the researcher.