Client’s satisfaction with maternal child health services in tier three public health facilities, Kisumu county, Kenya

Abstract

Purpose: The declaration of free maternal and child Health services by the government of Kenya was meant to address some of the systemic service access challenges and increase the number of clients using MNCH services, consequently reducing maternal and neonatal deaths. However, persistent poor maternal and child health indicators in Kenya even with free MNCH services as evident in Kisumu County portends considerable concern hence the reason for this study. There was need to identify factors or factor combinations that affect MNCH service quality in Kisumu County.Methodology: This was a descriptive analytical study whereby data was collected from a sample of 284 mothers seeking MNCH services in Kisumu tier three public health facilities using structured questionnaires and data was analyzed using the Statistical Package for the Social Sciences. Univariate statistics was used to assess patterns of responses to the client satisfaction questionnaire items. Bivariate logistic regression was used to assess association between client satisfaction and dimensions of their characteristics; p-values of less than 0.05 were considered significant.Results: Mothers aged 30-39 years were more likely to report being satisfied with maternal, newborn and child health services as compared to those aged 15-19 years (aOR=0.52, 95%CI=0.28-0.96, p-Value=0.035). The clients who had 1 pregnancy (aOR=2.29, 95%CI=1.04-5.05, p-value=0.040) and 2 pregnancies (aOR=3.22, 95%CI=1.54-6.70, p-Value=0.002) were more likely to report being satisfied with maternal child health services in public health facilities. Similarly, there was significant increased odds of being satisfied among those who resided in rural areas (aOR=2.24, 95%CI=1.05-4.79, p-Value=0.037), those who use vehicles as means of transport (aOR=6.87, 95%CI=1.38-34.28, p-Value=0.019) and those who use motorbike as means of transport (aOR=7.79, 95%CI=1.61-37.77, p-Value=0.011) and maternal child health services satisfaction.Unique contribution to practice and policy: The feedback from this study can be used by national and county governments, state agencies and other health stakeholders in designing communication and advocacy strategies for targeted groups or populations both at the community and health facilities to increase access and acceptability of MNCH services.