Determinants of utilization of free maternal health care in Muhuru and Nyatike divisions, Nyatike sub county, Kenya

Abstract

The free maternal health care was introduced in the year 2013 to improve access to maternal care for Kenya to meet the fifth millennium development goal which is to improve maternal health, to reduce maternal deaths and to make safe maternal care accessible to many people. The program however has had so many challenges that are still affecting its effective implementation to achieve its intended objectives. There is a higher rate of women seeking the services compared to the numbers that are actually served implying that there is a gap in demand and provision of the service. The study sought to explore the determinant of utilization of free maternal health care. It had four objectives namely: To establish the level at which socioeconomic factors influence utilization of free maternal health care. To assess the extent to which administration of the free maternal care influence the utilization of free maternal health care. To examine how mothers’ attitude influence utilization of the free maternal health care. To examine how knowledge of mothers on free maternal health care influence the utilization of free maternal health care. To assess these objectives, the study will involve a descriptive survey design. The study involved a population of 9960 women attending post natal care and from this probability proportional to size (PPS) sampling method was used to sample the respondents to be chosen from the different health facilities a sample of 370 women, 12 CHWs in Nyatike Sub County and 5 CHWs in Muhuru division took part in the study. Split half technique was used to determine the reliability of the questionnaire. This involved administering the same questionnaire twice to mothers and Community health workers in one health facility which was excluded from the actual study. They were administered respectively to explore the determinant of utilization of free maternal health care and analyzed using descriptive statistics. Descriptive statistics included frequency tables and cross tabulation. Computer based package such as SPSS was useful in the analysis after which the findings were interpreted arrived at the conclusions and recommendation based on the study findings. The study findings established that, utilization of the free maternity care was associated with access to information on the free maternal care by the health facilities this is so because a proportion of 92.7% of the mothers who used the free maternity care had access to the information on the services from health facilities. The study shows that quality services at the health facility level influenced utilization of free maternal health care among women. Hospital physical conditions, availability of social amenities such as water supply, functional toilet and all necessary equipment also greatly influenced women decision to utilize the free maternal health care. There was also relation between cost and utilization with facility charging no extra fee registering more mother than those that charged. A significant number of women received the information through the radio in comparison to the other media of communication channels this calls for deliberate action from the service providers to target radio and put strategies to use print and other channels. It is therefore important for the health professionals to understand the barriers that hinder women from utilizing the free maternal health care as this provides evidence to address women’s problems using the community strategy model rather than the medical model that only looks at the current disease map as the only problem of the client.