Influence of expanded free maternity care programme on delivery of quality health care in maternity units in public health facilities in Kajiado County

Abstract

A well-functioning health system works in harmony among the six pillars; trained and motivated health workers, functional infrastructure, consistent supply of essential medicines and technologies and sufficient funding.Africa is uniquely affected by maternal health challenges with a maternal mortality estimated at 686/100,000 live births. These deaths are avoidable with proper medical intervention.Kenya has high maternal mortality estimated at 360/100,000 live births.This study sought to assess quality of service delivery in maternity units of health facilities currently implementing expanded free maternity care programme in Kajiado County. It was guided by one general objective; to assess the influence of expanded free maternity care programme on delivery of quality health services and four specific objectives which were to establish how essential drugs, medical equipment, health workers and basic amenities influence quality of health services in maternity units of public health facilities in Kajiado County. The study adopted descriptive cross sectional design of survey. All the 44 health workers in labour wards who included midwives, clinical officers and medical officers were sampled. Likert based psychometric construct, self-administered questionnaire was used to collect data. Data analysis was done using Statistical package for social scientist’s software and results tabulated using frequency distribution tables. Descriptive and inferential statistics were used to provide population details and make inferences. The study found that: Health worker factors positively and significantly influenced delivery of quality of healthcare services (r= .655**, P < .001); basic amenities positively and significantly influence delivery of quality healthcare services (r= .350**, P < .020). There was positive association between availability of essential drugs and delivery of quality healthcare services r= .302**, P < .047). However, there was no association between medical equipment and delivery of quality healthcare services r=.338**, P < .006). An improvement in human resource factors and basic amenities would lead to an improvement in delivery of quality services. The study recommends that the County government of Kajiado should a) establish practical modalities for maintenance and replacement of worn-out medical equipments, b) deploy adequate staff to level 2 and 3 health facilities especially those in rural and far-to-reach areas, and c) establish a County fund to enable timely provision of essential drugs, d) prioritize provision of adequate water and reliable power source for all rural health facilities.