Determinants of Health Facilities Influencing Utilization of Free Maternity Services Among Women of Reproductive Age 15-49 Years Attending Health Facilities in Homa-Bay County

Abstract

Free maternity services is the offering of medical and obstetric care to pregnant women without any financial cost. Complications related to pregnancy were a major reproductive health problem that lead to disability and increased maternal deaths. Free maternity was introduced in Kenya in 2013 with a focus of achieving 100% utilization of the service and reducing high mortality rate. Homa-Bay County had a low percentage of 54% deliveries taking place in health facilities within the county. The main objective of this study was to establish Determinants of Health facilities Influencing Utilization of Free Maternity Services among Women of Reproductive Age 15-49 Years Attending Health Facilities in Homa-Bay County. Descriptive cross-sectional study design was applied to establish the main objective of this study. A probability and non-probability sampling techniques was used to select 420 respondents. The study utilized quantitative and qualitative methods of data collection. Data analysis was conducted with aid of Statistical Package for Social Scientists (SPSS) version 23. Analysis methods used were; factor analysis and regression analyses methods for quantitative data to determine the relationship and associations among the variables. Qualitative data was analyzed through content analysis by conducting thematic analysis. A total of 396 that was 94% response rate established 54% (213/396) mothers were interviewed and were aged between 20 years and 29years. Results showed that; age of the mothers was insignificant in utilization of free maternity services. Further analysis using logistics regression revealed that the respondents who agreed with the need for a well-equipped health facility with good sanitation system were 63% (OR 0.37, p = 0.03) more likely to reuse FMS. Distance was insignificant in utilization as long as the facility was well-equipped and adequately staffed as 57% (228/396).This study concluded that there was significant association between staff respect, and honesty of the staff with utilization of free maternity service. This study recommended that the County Government of Homa-Bay should increase awareness to women of reproductive age at the community level about FMS through Community health promotion officers in order to improve FMS uptake in Homa-Bay County.