Does Free Maternal Services Provide Access to Skilled Birth Attendants?: A Case of Level 5 and 6 Public Hospitals in Kenya

Abstract

Pregnancy and motherhood are natural processes in lives of women of reproductive age. These processes are supposed to be fulfilling experiences. However maternal mortality during the process is still a major public health problem. The progress of reducing these preventable deaths is still low especially in developing regions. In the absence of complications, pregnancy is a simple and natural process that requires little external intervention. Due to unpredictability of birth outcome, skilled attendance at delivery is recommended in a healthy facility. Therefore, the main objective of this study is to identify the challenges associated with free maternity services in levels 5 and 6 public health facilities in Kenya. The specific objectives include; first, to identify ratio of specialized staff to pregnant women and secondly, to investigate the staff and infrastructure on utilization of free maternity services. The study adopted cross sectional descriptive design. Also, facility based secondary data was used and the random effects GLS regression model was employed. The study results showed significant increased utilization of services in hospitals with more obstetricians, ambulances and beds. The proportion of specialized staff to deliveries was very low implying challenges to service provision given the provision of free maternity services. Based on results, the study concluded that there is a need for the government to consider increasing funding to secure more and better good infrastructure facilities like ambulances and beds. Finally, there is a need of government and stakeholders of developing a policy and policy guidelines to guide counties in implementation of free maternity services.