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Citation Information

Type Journal Article - Public Health Action
Title Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007-2013
Volume 5
Issue 1
Publication (Day/Month/Year) 2015
Page numbers 23-29
URL http://www.ingentaconnect.com/content/iuatld/pha/2015/00000005/00000001/art00005?crawler=true&mimety​pe=application/pdf
Setting: A rural private health facility, Ruby Medical Centre
(RMC), participating in a safe motherhood health
voucher system for poor women in Kiambu County,
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.

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