SATISFACTION LEVELS OF FREE MATERNITY SERVICES AT KABARNET COUNTY HOSPITAL
Keywords:
Maternal mortality rate, Skilled assisted deliveries, Free Maternity ServicesAbstract
Background: Skilled attendance during delivery is known to reduce maternal mortality. However inequitable access to it in developing countries has lead to perpetual poor maternal health statistics. A high maternal mortality rate of 546 was recorded by World Health Organization in 2015 for countries in sub-Saharan Africa. Kenya was among countries with a high maternal mortality at 510. The government of Kenya implemented free maternity services in June 2013 to remove financial obstacles, enhance equity in access of maternity services and improve maternal outcomes during delivery. Its sustenance and quality was however not certain because of longstanding challenges in the health sector. The study sought to determine satisfaction levels of mothers regarding maternity services accorded to them.
Methodology: This was a cross sectional study conducted at Kabarnet County Hospital among women attending maternal child health clinic who had a birth within three years from the time of the study. A sample size of 379 was obtained using Cochran's formula and systematic random sampling. Data was collected through structured questionnaires and analyzed using SPSS version 20. Chi square tests were done to determine associations between various variables in the study. Results are presented in form of tables, charts and percentage.
Findings: Majority of participants had socio demographic factors which promote skilled assisted deliveries. A good service was the main reason for choosing a place of delivery. Staff competency was noted to be the most satisfactory factor rated at 91.1% while insufficient materials and equipment was the most unsatisfactory by 30.2% cumulatively. Significant differences on the condition of mother and baby depending on delivery assistant was noted with Chi-Square test of 38.7 and 32.4, P value 0.029 and 0.020, respectively
Conclusion: Free maternity services were accessible and satisfactory hence the high proportion of skilled assisted deliveries.
Downloads
References
2. World Health Organization. Skilled attendants at birth. WHO. 2014. http://www.who.int/maternal_child_adolescent/topics/maternal/skilled_birth/en/
3. World Health Organization (2014). Global Health Observatory (GHO) - Skilled attendants at birth. Available at: http://www.who.int/gho/maternal_health/skilled_care/skilled_birth_attendance_text/en/
4. KNBS, Ministry of Health, NACC, KEMRI, NCPD, The DHS program -ICF international. Kenya Demographic and health survey 2014. Republic of Kenya. 2015
5. World Health Organization (2013). The world health report 2013: research for universal health coverage. http://www.who.int/whr/2013/report/en/
6. Alvarez, J.L., Gil, R., Hernández, V., and Gil, A. Factors associated with maternal mortality in Sub-Saharan Africa. Bio Med Central. 2009; DOI: 10.1186/1471-2458-9-462. Available from:
http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-9-462
7. Levine, R. (2007). Case Studies in Global Health: Millions saved case 6; saving mothers in Sri Lanka. https://www.cgdev.org/page/case-6-saving-mothers-lives-sri-lanka, Jones and Bartlett Publishers, Inc. ISBN-13: 978-0-7637-4620-9.
8. Peters D.H., El-Saharty S., Siadat B., Janovsky k., and Vujicic M. Improving Health Service Delivery in Developing Countries. The World Bank. 2009. Available from: http://elibrary.worldbank.org/doi/pdf/10.1596/978-0-8213-7888-5
9. Schneider, H. and Gilson, L. (1999).The impact of free maternal health care in South Africa. Department of international development. Available at: http://www.popline.org/node/525240
10. Fadila J, Ogujiuba K, and Stiegler N. Health Sector Reform s: Implications for Maternal and Child Healthcare in South Africa. Mediterranean Journal of Social Sciences. 2013; ISSN 2039-9340, Vol 4 No 6 Doi:10.5901/mjss.2013.v4n6p593
11. Kippenberg, J. (2006). A High Price to Pay Detention of Poor Patients in Burundian Hospitals. Human Rights Watch, Volume 18, No. 8(A). Available at: https://www.hrw.org/reports/2006/burundi0906/burundi0906web.pdf
12. Hulton, A.L., Matthews, Z. and Stones, R.W. A framework for the evaluation of quality of care in maternity services. University of Southampton. 2000; ISBN: 0854327029. . Available from: http://eprints.soton.ac.uk/40965/1/12757_Matthews.pdf
13. Ministry of Health. Status of implementation of free maternity services (FMS) in the devolved health system in Kenya. A comprehensive assessment report. 2015.
14. Ministry of devolution and planning. Millennium development goals, status report for Kenya. Republic of Kenya. 2013.
15. NCAPD, MMS, MPHS, KNBS and ICF Macro, (2011). Kenya Service Provision Assessment Survey 2010. NCAPD, MMS, MPHS, KNBS and ICF Macro. Available at: https://dhsprogram.com/pubs/pdf/SPA17/SPA17.pdf
16. United Nations, Secretary-General, (2010). Global Strategy for Women's and Children's health. World Health Organization . Available at: http://www.who.int/pmnch/topics/maternal/20100914_gswch_en.pdf
17. Institute of Economic Affairs (2014). Budget Guide, Budget 2014/2015: Balancing financing concerns while responding to spending inefficiencies. Available at:
https://www.ieakenya.or.ke/downloads.php?page=BUDGET-GUIDE-2014---2015.pdf
18. World Health Organization (2011). The Abuja declaration: Ten years on. Available at: http://www.who.int/healthsystems/publications/abuja_report_aug_2011.pdf
19. Government of Kenya. The 2009 Kenya population and housing census - population distribution by age, sex and administrative units. KNBS. 2010. Available at; https://www.knbs.or.ke/category/census-2009/
20. Wisdom, J. and Creswell, J., (2013). Mixed Methods: Integrating Quantitative and Qualitative Data Collection and Analysis While Studying Patient-Centered Medical Home Models. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Publication No. 13-0028-EF.
21. Cochran, W. G. Sampling Techniques, Third edition. New York: John Wiley and Sons, Inc. 1977. Available from: http://hbanaszak.mjr.uw.edu.pl/StatRozw/Books/Cochran_1977_Sampling%20Techniques.pdf
22. Karkee R., Andy H. L. and Pokharel P. K. Women's perception of quality of maternity services: a longitudinal survey in Nepal. BMC Pregnancy and Childbirth. 2014. DOI: 10.1186/1471-2393-14-45
23. Rowland T., McLeod D., and Froese-Burns N. Comparative study of maternity systems. Malatest International. 2012. Available from: https://www.health.govt.nz/system/files/documents/publications/comparative-study-of-maternity-systems-nov13.pdf
24. Bitew, K., Ayichiluhm, M. and Yimam, K. Maternal Satisfaction on Delivery Service and Its Associated Factors among Mothers Who Gave Birth in Public Health Facilities of Debre Markos Town, Northwest Ethiopia. BioMed central, Research International. 2015; Article ID 460767
25. Bazant, E.S. and Koenig M. A. Women's satisfaction with delivery care in Nairobi's informal settlements. International Journal for Quality in Health Care. 2009; 21(2):79-86. doi: 10.1093/intqhc/mzn058. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19208648
26. Esena, R.K. and Sappor, M. (2013). Factors Associated With The Utilization Of Skilled Delivery Services In The Ga East Municipality Of Ghana Part 2: Barriers To Skilled Delivery. International journal of scientific & technology - Vol.2, Issue 8, Available at: http://www.ijstr.org/final-print/aug2013/Factors-Associated-With-The-Utilization-Of-Skilled-Delivery-Services-In-The-Ga-East-Municipality-Of-Ghana-Part-2-Barriers-To-Skilled-
27. Esena, R.K. and Sappor, M. (2013). Factors Associated With The Utilization Of Skilled Delivery Services In The Ga East Municipality Of Ghana Part 2: Barriers To Skilled Delivery. International journal of scientific & technology - Vol.2, Issue 8, Available at: http://www.ijstr.org/final-print/aug2013/Factors-Associated-With-The-Utilization-Of-Skilled-Delivery-Services-In-The-Ga-East-Municipality-Of-Ghana-Part-2-Barriers-To-Skilled-Delivery.pdf.
28. Koblinsky, M.A., Campbell, O. and Heichelheim, J. (1999). Organizing delivery care: what works for safe motherhood? Bulletin World Health Organization; 77: 399-406, PMC2557673
29. Galadanci, H.S, Idris S. A, Sadauki H.M. and Yakasai I.A. Programs and Policies for Reducing Maternal Mortality in Kano State, Nigeria. A Review African Journal of Reproductive Health. 2010 (Special Issue); 14(3): 31
30. Hatt L.E., Makinen M., Madhavan S. and Conlon C.M. Effects of User Fee Exemptions on the Provision and Use of Maternal Health Services: A Review of Literature. The Journal of Health, Population and Nutrition. 2013; 31(4 Suppl 2): S67-S80.
31. Khammany, P., Yoshida, Y., Sarker, M.A.B., Touy, C., Reyer, J.A. and Hamajima, N. (2015). Delivery care satisfaction at government hospitals in Xiengkhuang Province under the maternal and child health strategy in Lao PDR, Nagoya Journal of Medical Sciences, 77(1-2), PMCID: PMC4361509
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
