Abstract:
High maternal mortality is a global issue. According to world health organization
developing countries especially in sub-Saharan Africa bore the greatest brunt. Kenya was
among the ten countries with very high maternal mortality ratio, at 510 per 100,000 live
births. Free maternity services program was launched in June 2013 in government
facilities to improve skilled attendance at birth, hence reduce maternal mortality.
Inadequate preparation evident by a lack of a strategic plan and existing deficiencies in
public maternity facilities made the program’s success uncertain. The objective of the
study was to determine factors associated with uptake of free maternity services amongst
women attending maternal child health services at Baringo county referral hospital. It was
a facility based cross sectional design, a sample of 379 was obtained using Cochran’s
formula and systematic sampling applied. Data was collected through semi structured
questionnaire, a focus group discussions and key informants interviews. Ethical clearance
was obtained from Kenyatta National Hospital / University of Nairobi ethical review
committee. Quantitative data was analyzed using Statistical Package for Social Sciences
while qualitative data was manually done based on themes. Of the 379 participants
interviewed, above 70% were; 21 to 30 years, married and with secondary education.
Three quarter chose place of delivery due the good reputation of the facility and 95.8% of
the deliveries were in government facilities. Significant association to uptake of free
maternity services were; reason of availability of modern equipment /technology
(P=0.007, OR=43.357) and having a referral /expected complications (P=0.018,
OR=42.732). Satisfaction of maternity services was significantly associated with reason
of modern equipment /technology and courteous staff (p-value=<0.01, OR=0.041) and (pvalue=< 0.01, OR =0.062) respectively. In conclusion availability of modern equipment
/technology and referrals enhanced utilization of free maternity services. Therefore
maternity facilities should be well furnished with modern equipment /technology and
should have clearly outlined and functional referral systems to enhance skilled attendance
at birth.
