Determinants of the Uptake of Free Maternity Services among Pregnant Mothers in Malava Sub-County, in Kakamega County, Kenya

Abstract

Over the past decade, Kenya has made tremendous efforts to enhance maternal and child health. Secure maternity policies such as free maternity care are one of the initiatives that have enhanced maternal and child health in all public health facilities. Despite these attempts, public health facilities for maternal and child health are still underused. This study employed a cross-sectional descriptive study design to identify determinants of free maternal health services by evaluating factors determining perceptions and health-seeking behavior of 384 pregnant mothers in Malava Sub-County, Kakamega County. The study used a mixed-method (quantitative and qualitative approaches). Questionnaires were administered to pregnant mothers selected for the study. The study employed a purposive sampling of research participants. Quantitative data were collected using the questionnaire administered by the research assistants whereas qualitative data were collected by the researcher through interview schedules. Quantitative data analysis was carried out using SPSS 23. However, qualitative data were analyzed through content analysis. Quantitative data representation was done in terms of frequency and percentages. Analysis of chi-square testing was used to assess the association between the variables of socio-economic and health facilities and the provision of free maternity facilities (p<0.05). The study established that the uptake of free maternal service by pregnant mothers was influenced by their level of primitivism and religious beliefs. In addition, this study found out that 53.8% and 77.7% of the pregnant mothers could not attend antenatal and post-natal care because government facilities were located far away from their residences and they also had less access to some information about free maternal health care. The results of this research would be disseminated to the hospital management team, Sub-Country health management team, County health management team, and other stakeholders, thereby demonstrating reasons for low uptake of free maternity services and helping to strategize for better service delivery. Based on the finding, the study recommends that to improve access to free maternal health care, the county government ought to place health services as close as possible to the community where people live. Secondly, there is a need to embrace the usage of the existing media network to sensitize pregnant mothers to the danger signs and the need to have decision-making powers over their safety. Lastly, hospital management ought to increase the awareness of free maternal health care and to include it among the community priorities during dialog days, action days, and other group discussions.