Factors influencing the implementation of free maternal healthcare services in Kenya: a case of public hospitals in Nairobi county

Abstract

The purpose of this study was to evaluate factors influencing implementation of free maternal healthcare services in public hospitals in Kenya. This was a descriptive study focusing on process of implementing and results thereof. The study was guided by the following research objectives (i) To determine the influence of hospital infrastructure on implementation of free maternal healthcare services in public hospitals in Kenya. (ii) To determine the influence of resources on implementation of free maternal healthcare services in public hospitals in Kenya. (iii) To establish knowledge of women on implementation of free maternal healthcare services in public hospitals in Kenya. (iv) To determine the quality of services and implementation of free maternal healthcare services in public hospitals in Kenya. The data was collected using questionnaire and interview schedule. Respondents included patients/ women who had delivered in public hospitals and one mid wife from each of the study sites .Data was analyzed through descriptive statistics using statistical package for social science (SPSS 20) in order to give quantifiable statistics and the results done with the help of Microsoft office excel programme and results presented in tables. Validity and reliability of the instrument was done through content analysis and half split test to determine whether it addressed all relevant aspects of variables. The key findings of the study revealed that hospital infrastructure; resources have a direct effect on implementation of free maternal healthcare services in public hospitals. While knowledge and quality has a direct impact on whether patients will utilize free maternity services being provided in public hospitals in Kenya. The study recommended that the government should develop both long term and short term strategies in implementing free maternal healthcare services in public hospitals. The government ought to establish mechanisms which will ensure more maternity wards are built, the number of wards should directly relate to the number of patients visiting the facilities , the government also need to provide basic maternity equipment in all its health centre , sub districts hospital in order to help decongest existing facilities . In line with the government commitment through the Abuja declaration of 2001 the government needs to allocate up-to 15% of the national budget to ministry of health. Also the government need to employ more mid wives since the current ration stands at 1:10 against the recommended ration of 1:1 for critical patients or 1:3 for stable patient.