Factors influencing the quality of free maternity services: a case of Chuka general hospital, Tharaka Nithi county

Abstract

The free maternity services program entails the provision of antenatal, intrapartum and postnatal care services free of charge in all government health facilities. The program was established by the government of Kenya in a bid to improve maternal and infant health by enhancing access to care at all public hospitals and hence reduce maternal and infant mortality in the country. There has been a significant increase in the number of patients seeking maternity services in public hospitals since the introduction of the program. Despite the increased access to care, there are many challenges facing the delivery of services under the free maternity services program. This is mainly because the state of many public health facilities remains largely unchanged hence compromising their capacity to deliver quality care to the increasing number of patients. These challenges have hence slowed the accomplishment of its goals. The purpose of this study was to examine the factors influencing the quality of free maternity services, a case of Chuka General Hospital. The study employed descriptive survey research design. The target population was the health workers working in all the departments involved in the delivery of free maternity services. Purposive and simple random sampling techniques were used. A pilot study was conducted amongst health workers in the reproductive health clinic. This pretesting of the research instruments helped to establish the validity and reliability of the research instruments. Data collection instruments that were used included questionnaires, interviews and observation checklists. A desk review of the existing patient data was also conducted in the records department. Data was analyzed using descriptive statistics including frequencies and percentages which was facilitated through the use of Statistical Package for Social Sciences (SPSS) version 20.0 for windows. The findings indicated that the human resource capacity, healthcare financing & healthcare infrastructure had a significant influence on the quality of free maternity services at Chuka General Hospital. It is expected that the results of this study will be useful to the government in formulating strategies that will enhance the quality of free maternity services. The study revealed that Chuka general hospital had inadequate staffing and that the number of working hours per day has increased since the introduction of free maternity services. The study thus concludes that due to inadequate staff, hospitals have been unable to effectively implement the free maternity services program. The study further revealed that funds meant to finance the free maternity services program in Chuka general hospital are not availed in good time. Therefore, the study concludes that hospital have been unable to successfully implement the new policy to provide free care due to the fact that the funds are inadequate. The study further revealed that poor healthcare infrastructure and inadequate specialized facilities has to a great extent negatively affected the quality of free maternity services in Chuka General Hospital. Human resource capacity influenced quality of free maternity services by 69.3%; Health financing by 51.1% and healthcare infrastructure by 52.9%. Based on the findings from the study, the researcher recommends that more needs to done by the government to enhance the human resource capacity, healthcare infrastructure and healthcare financing so as to improve the quality of free maternity services offered under the free maternity services program.