Assessing service availability before and after the introduction of free maternity services at the Pumwani maternity Hospital

Abstract

Maternal health is the state of health of women during pregnancy, childbirth and the postpartum period. The Kenyan government introduced free maternal healthcare services in June 2013 to address the high maternal mortality rates that stood at 362 per 100000 live births in 2016. Maternal Mortality rate in Nairobi County was estimated to be at 57.1 per 100000 live births as of 2014. The study aimed at contributing towards strengthening maternity services by assessing the availability of maternity services before and after the introduction of the free maternity services policy at the Pumwani Maternity Hospital. This was a mixed method study; quantitative study (data from existing records) employing longitudinal study design and qualitative study where in depth interviews were conducted on six respondents using topic guides. This was simple and allowed evaluation of variables that change before and after interventions. The study was conducted in the month of February 2018 and was for the periods 2009 to 2017. The implementation of the free maternity services resulted to a 1974.75 mean increase in admissions, 1840.42 mean increase in total deliveries of which 1358.50 was increase in normal deliveries and 478.50 caesarian deliveries. These figures as seen in the analysis had not been recorded in the facility before and it is important also to note that these figures decline through the years. There was no much variation in the infrastructure, equipment and personnel and coping mechanisms largely relied on the Pumwani Maternity team. Similar studies are required both in the facility and the private entities to come up with recommendations on how to keep the numbers high and sustain the free maternity services policy. This study therefore contributes to knowledge that would inform policy in Kenya and other countries that seek to subsidize maternity services.