Factors Influencing Delivery of Maternal Healthcare Services in Public Healthcare Facilities in Nairobi County, Kenya: a Case of Kenyatta National Hospital.

Abstract

According to World Health Organization (WHO) more than 585,000 women of reproductive age (15-49 years) die each year from pregnancy related causes worldwide whereby 99 per cent of these deaths occur in third world countries. There is a movement globally and particularly in African regions to reduce maternal mortality rates through escalation of maternal healthcare interventions. The focus of this study is on factors influencing delivery of maternal healthcare services in public healthcare facilities in Nairobi County, Kenya with emphasis on several objectives which include; to determine the patients’ background factors influencing delivery of maternal healthcare services in public healthcare facilities, to establish the healthcare facilities factors influencing delivery of maternal healthcare services in public healthcare facilities, to examine the influence of medical devices in delivery of maternal healthcare services in public healthcare facilities and to determine the influence of staffing in delivery of maternal healthcare services in public healthcare facilities. The study was linked to realism theory. The target population was drawn from KNH Maternity wing which include 340 mothers, 30 nurses, 10 doctors and 15 biomedical engineers. The main data collection tools used for this particular study include: questionnaires and in-depth interviews. The sample size was achieved using the Krejcie and Morgan, 1970 table from the target population and a cross sectional descriptive research design was used. Validity of the research instruments was determined by construct of the instruments while reliability of the research instruments was determined through internal consistency method. Responses from open ended questions in the questionnaire and in depth interviews was categorized based on emerging themes which was used to supplement quantitative data and conclusion of the study. The data collected was analysed using qualitative and quantitative methods while SPSS was used for analysis of such data. Results of the quantitative data were presented through tables. The study revealed that based on healthcare workers perspective, patients’ background factors especially cost influences delivery of maternal healthcare services in the hospital. Both healthcare workers and mothers did not see travel time and cultural beliefs as influencing delivery of maternal healthcare services in the hospital. The study also established that in healthcare workers’ view, public healthcare facility factors especially hospital management and financial resources influence delivery of maternal healthcare services in the hospital. The mothers also viewed public healthcare facility factors as an influencing factor to delivery of maternal healthcare services especially because hospital management influences how maternal healthcare services are delivered to mothers in the hospital. However, mothers did not see availability of maternal healthcare information to mothers in the hospital and financial resources’ availability as influencing delivery of maternal healthcare services. The findings of this study have shown that based on healthcare workers perspective, maternal healthcare devices factors have a direct relationship to delivery of maternal healthcare services. Mothers were in agreement with the healthcare workers on the importance of maternal healthcare devices in maternal healthcare services delivery and emphasized on availability of these devices in hospitals. Staffing factors according to both healthcare workers and mothers play an important role on delivery of maternal healthcare services delivery. The healthcare workers and mother emphasized the importance of good or respectful relationship between mothers and healthcare providers in the hospital and opportunities for career advancement for the staff.