Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007–2013
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Date
2015Author
Kihara, A-B
Harries, A. D
Bissell, K
Kizito, W
Berg, Van Den
Mueke, S
Mwangi, A
Sitene, J. C
Gathara, D.
Kosgei, R J
Kiarie, J
Gichangi, P
Language
enMetadata
Show full item recordAbstract
Setting: A rural private health facility, Ruby Medical Centre (RMC), participating in a safe motherhood health voucher system for poor women in Kiambu County, Kenya.
Objectives: Between 2007 and 2013, to determine 1) the number of women who delivered at the RMC, their characteristics and pregnancy-related outcomes, and 2) the number of women who received an incomplete antenatal care (ANC) package and associated factors.
Design: Retrospective cross-sectional study using routine programme data.
Results: During the study period, 2635 women delivered at the RMC: 50% were aged 16–24 years, 60% transferred in from other facilities and 59% started ANC in the third trimester of pregnancy. Of the 2635 women, 1793 (68%) received an incomplete ANC package: 347 (13%) missed essential blood tests, 312 (12%) missed the tetanus toxoid immunisation and 1672 (65%) had fewer than four visits. Presenting late and starting ANC elsewhere were associated with an incomplete package. One pregnancy-related mortality occurred; the stillbirth rate was 10 per 1000 births.
Conclusion: This first assessment of the health voucher system in rural Kenya showed problems in ANC quality. Despite favourable pregnancy-related outcomes, increased efforts should be made to ensure earlier presentation of pregnant women, comprehensive ANC, and more consistent and accurate monitoring of reproductive indicators and interventions.
URI
http://www.ingentaconnect.com/content/iuatld/pha/2015/00000005/00000001/art00005http://hdl.handle.net/11295/81902
Citation
Kihara, A. B., et al. "Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007–2013." Public Health Action 5.1 (2015): 23-29.Publisher
University of Nairobi
Collections
- Faculty of Health Sciences (FHS) [10385]