Assessment of facility readiness to provice quality delivery services in Kenya
This study focused on structural and process factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to mothers during delivery; and the extent to which clients perceive services to be of high quality. Data was obtained from the 2010 Kenya Service Provision Assessment. The results show that most facilities in Kenya generally attained a medium score for facility readiness to provide quality care for mothers during Delivery. Many facilities lacked simple items like maternal and emergency delivery guidelines ipartographs and covered waste receptacles. Many facilities did not show evidence of discussing Delivery data to make decisions and providing skilled delivery for home deliveries in addition to; poor linkage of the facility and traditional birth attendants in order to provide home based skilled delivery. There were marked differences in facility readiness by region and type of facility. For Facility readiness, Nairobi region performed best with no facility attaining a low score. Coast region performed equally well with Three government facilities attaining a high score. Nyanza had only one Government facility that attained a high score. In contrast Eastern, North Eastern, Rift Valley and Western Provinces had no facility that attained a high score. More Resources and Support structures need to be in place for North Eastern, Eastern, Rift Valley and Western regions in order to improve the quality of care to the level of Coast, Central and Nairobi regions. The community component of the study that was used to support the quantitative findings was used to reveal perceptions and attitudes of the community towards the Government facilities. The discussions with the Community Health Workers revealed that mothers in the community are aware of the importance of delivering in the facilities; however most of them prefer to deliver with Traditional Birth Attendants. The Main reasons given by the Community were that the mandatory HIV test done before delivery discourages the mother form Hospital delivery, Delivery costs at Government facility, Distance to the facility, Instances of harassment and abuse from the health care workers during delivery, pre conceived perceptions about the qualification of Health care workers in the facility and cultural beliefs.