Factors Influencing Uptake of Free Maternity Services in Kakamega County 5 Years After Introduction

Abstract

Background: Delivery with skilled birth attendance and access to basic and emergency obstetric care is the most crucial intervention for reducing maternal and new-born deaths. A significant proportion of women in Kenya especially those in rural settings deliver at home alone or with the help of TBAs. Health care charges are a significant barrier to access to skilled maternal health services. In June 2013 free maternity services was introduced in Kenya to encourage women to deliver in a public health facility .However, according to the KDHS 2014, 38% of women in Kenya still had home deliveries.In Kakamega County home deliveries were at 50.6 % Objective: To determine the factors influencing choice of place of delivery among women in Kakamega county five years after the introduction of free maternity services in public hospitals in Kenya. Methodology: This was an analytical study carried out at Kakamega County Referral Hospital MCH clinic among 416 women attending the MCH clinic for post-natal care services. Descriptive statistics in form of percentages were used to summarize the data values for the study variables. Chi-square test was used with p-value <0.05 considered significant. The analysis was done using the SPSS computer software version 24. Results:Most of the respondents had facility based deliveries with 85% having hospital deliveries. Women who delivered at home were significantly older than those who delivered in a health facility (32.5yrs versus 25.8 yrs.) p< 0.003. Being single was associated with delivery from a health facility (p < 0.0001). Women who stayed more than 5km from the facility were more likely to deliver at home p< 0.004. ANC attendance especially in the first trimester was associated with more facility delivery, p<0.0001. Conclusion: Based on the study results the proportion of women delivering in a health facility is higher than the national average.There is need to improve access and transport to health facility as it is a major reason given for home delivery based on the study findings