Determinants for utilization of free maternal services in Kenya
Complications of pregnancy and childbirth can lead to increased deaths and disability than any other reproductive health problems. In order to reduce the health risk of both the mother and the un-born baby, there is need to increase utilization of healthcare services during delivery. Individual and community disparities are associated with low utilization of maternal health care in Kenya. Reversing the high maternal mortality rate is very vital in achieving vision 2030. Despite the fact that the government of Kenya embarked on an ambitious program (free maternal program) unfortunately only 61% of deliveries take place in health facilities according to the recent demographic health survey. In order to design effective policies and succeed in promoting welfare of mothers, with low maternal mortality, this study has explored factors influencing utilization of maternal health care services in Kenya using Kenya Demographic and Household Survey (KDHS, 2014). Three binary models were estimated, that is a model for antenatal care, hospital delivery and postnatal care respectively. The study results revealed; age of the mother, age of the mother at first birth, higher education level, birth order, being a catholic, being a Muslim, all wealth indexes, mass media and all regions except North Eastern and Nyanza regions had increased likelihood in the usage of antenatal care. Age of the mother at first birth, secondary education, higher education level, birth order, urban residence, poorer wealth quintile, middle wealth quintile, richer wealth quintile, richest wealth quintile, mass media and regions increased the probability of hospital delivery usage. For the Postnatal the key variables that increased the likelihood of it usage were; age of the mother, birth order, middle, richer and richest wealth quintiles, and central regions were statistically significant in determining usage of postnatal care services in Kenya. Based on the findings, this study recommends for a need to invest in education (i.e. secondary and higher education) especially female education which can promote usage of antenatal and hospital delivery among pregnant women in Kenya. Also, there is a need for the government to introduce more programmes meant to improve wealth status of households since it was associated with higher usage of hospital delivery and postnatal care. The government should consider involving religion as a channel for promoting usage of these maternal health services as religion raised likelihood of using antenatal and hospital delivery. On the other hand, effective, better and thus improved service delivery at health facilities located in North Eastern and Nyanza regions is vital since these regions were associated with lower usage of antenatal care. This action by the government will reverse the trends on utilization of maternal health services in these regions.
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