Factors Influencing Implementation of Free Maternal Health Care in Government Health Facilities: a Case of Kisima Location; Samburu County, Kenya

Abstract

Issues concerning maternal healthcare are highly prevalent in most developing nations as the quality of care is often low and too expensive for the local population. Kenya, like most other developing nations, has shown the desire to show its commitment towards reducing the problems associated with implementation of free maternal health care projects and programmes. The government’s implementation strategy involved introduction of free maternal healthcare program in counties and regions that have limited healthcare services, through the devolution programme. Despite the plans to improve the maternal health care, Lorroki Division in Samburu County has the highest number of maternal health care problems with the high numbers in Kisima Location. The purpose of this study was to establish factors influencing implementation of free maternal health care in government health care facilities in Kisima Location. The objectives of the study were to; assess how demographic characteristics influences implementation of free maternal health care, determine how attitude of health care providers influences implementation of free maternal health care, assess how the level of awareness on maternal health influences implementation of free maternal health care and assess how availability of resources influences implementation of free maternal health care. An in-depth review of literature was done. A descriptive survey design was used in this cross sectional study. The target population was Lorroki Division residents and accessible population was Kisima Location residents from which a sample of 202 residents were selected using stratified sampling; 80 adult women, 75 men and 47 youth . Purposive sampling was used to select 10 health care providers. Data was collected through questionnaires, document reviews and interviews and descriptive statistics was used to analyse the data with aid of Statistical Package for Social Sciences version 20.Content analysis was applied for the qualitative data.The study established that 76.2% of the respondents were unemployed and 50% were uneducated. The quality of health care services was rated to be good but attendance on antenatal and post natal clinics was too low. There were two health facilities in Kisima location; Kisima and Mparigon.1 ambulance was available for the whole location. It was recommended that health care should be given priority and a favorable approach to maternal health care that covers from antenatal to postnatal stage should be introduced. Traditional birth assistants need to be trained on modern safe delivery skills. The study will aid in improvement and implementation in the health sector and thus overall promotion of comprehensive maternal health care services in Kenya.