Maternal and newborn health (MNH) includes the provision of adequate nutrition,
improved hygiene practices, antenatal care, and skilled health workers assisting at
births, emergency obstetric and newborn care, and post-natal visits for both mothers
and newborns. Most of the pregnancy-related maternal and newborn health issues
have been proved to be preventable by the access to essential maternity and basic
health-care services. Mothers and newborns health is usually related so preventing
deaths and health complications usually requires employing the same interventions.
The implementation of the free maternity program has brought about various issues.
Accessibility, utilization and the various challenges that are affecting the
implementation of the free maternity program are some of the emerging issues that
have frequently faced the implementation and utilization of the free maternity
program.
The purpose of this study was to assess the effect of the free maternity programme on
the access and outcomes of maternal and newborn health (MNH) in the County of
Kiambu. This study was guided by the following research questions: Estimate the
access and utilization of maternity services within public and private health facilities
in the County of Kiambu, How has the introduction of free maternity services
affected mortality and morbidity rates in Kiambu County? What are the challenges
associated with the free maternity program implementation?
The study employed a descriptive research design to access the effects of the free
maternity programme on the access and outcomes of maternal and newborn health
(MNH) in the county of Kiambu. A target population is the researcher’s population of
interest. This study targeted level four and level five hospitals in Kiambu County. In
total, there are two level five hospitals and four level four hospitals with a total staff
of 800 including doctors, medical surgeons, nurses, laboratory technicians, allied
health professionals and other hospital staff. The study adopted simple random
sampling to select a sample size of 171 members of staff out of the total 800 staff
available. The study collected both primary and secondary data. The research
instruments adapted in this study to collect primary data were questionnaires. Data
from questionnaires were summarized, coded, tabulated and analyzed. Editing was
done to improve the quality of data for coding. Coded data was then fed into the
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statistical package for social sciences (SPSS) version 21 for analysis. The completed
questionnaires were edited for completeness and consistency, checked for errors and
omissions and then coded and analyzed qualitatively and quantitatively. Qualitatively
the data was sought into themes, categories and patterns.
The study found out that the high transportation costs impacts on patients need to
access our facility, free maternal health service was shunned for fear of poor quality
of health care, maternal healthcare user fees hinders access healthcare increasing
mortality rate, lack of facilities to handle deliveries leads to high maternal morbidity
and mortality rates, women deeply rooted in their tribes’ traditions rarely visit our
health facilities for maternal care, poor infrastructure at our facility affect utilization
of maternal health care.
The study concludes that low level of education impacted negatively on women’s use
of our facility’s maternal services, poor economic status affected the use of hospitals
for delivery of children. Antenatal (ANC) utilization rate is still low due to lack of
ANC services at our hospital facility, maternal healthcare user fees hinders access
healthcare increasing mortality rate, lack of facilities to handle deliveries leads to high
maternal morbidity and mortality rates, free maternal healthcare has reduced mortality
rates, the introduction of free skilled care delivery services has improved the access to
health services for the poor, high transportation costs impacts on patients need to
access our facility, free maternal health service was shunned for fear of poor quality
of health care, the risk of infections like HIV/AIDS by health workers is another
challenge, low morale among the working staff is a hindrance to free maternal
healthcare.
The study recommends that education and literacy programmes should be set aside
among women in Kenya concerning maternal care, the government should reduce the
transportation costs of women seeking maternity care through provision of ambulance
services, the management of health units should expand and grow their facilities to
reduce congestion, the national government should subsidies the maternal healthcare
fees to make the facility attractive and affordable to women of low economic status,
health units should be properly with adequate facilities to handle deliveries