Influence of Expanded Free Maternal Care Programme on Delivery of Quality Health Care in Maternity Units in Kajiado County

Abstract

Introduction: A well-functioning health system works in harmony among the building blocks: trained and motivated health workers, functional infrastructure, consistent supply of essential medicines and technologies, health information management, and sufficient funding. Africa is uniquely affected by maternal health challenges with a maternal mortality estimated at 686/100,000 live births. Kenya has high maternal mortality estimated at 360/100,000 live births. These deaths are avoidable with proper medical intervention. This study sought to assess quality of service delivery in maternity units of health facilities currently implementing expanded free maternal care programme in Kajiado County. It was guided by one general and four specific objectives: To establish how essential drugs, medical equipment, health workers and basic amenities influence quality of service delivery in maternity units of health facilities currently implementing expanded free maternal care programme in Kajiado County. Methods:The study adopted descriptive cross sectional design of survey, with midwives, clinical officers and medical officers being the target population. Since the target population was small a census was carried out. 44 self-administered questionnaires were used; the questionnaires were pre-tested for reliability using Cronbach’s-Alpha. Descriptive and inferential statistics were used to provide population details and make inferences based on data collected. Results:68% of the health facilities surveyed were dispensaries (Level 2), 23% were Health centres (Level 3), 7% were Sub County referral hospitals (Level 4) while 2% were County referral hospital (level 5). Oxytocin injectable was partly out of stock in 64% of health facilities while Magnesium sulphate was always available in only 5% 58% of assessed health facilities had a sterile delivery set. Only 18% of respondents agreed that their facilities had adequate skill mix of health workers. None of the independent variable had coefficient > 0.05 hence no problem of multi-collinearity, the probability value, p was <0.05 indicating the model used was entirely significant. Conclusion:Results show independent variables individually and combined significantly influenced provision of quality of health care in maternity units in Kajiado County Kenya