Effect of free maternal health policy on delivery of services in Machakos level five Hospital
The World Health Organization (WHO), approximates that 830 women die every day from preventable causes related to pregnancy and childbirth with ninety-nine percent of these maternal deaths occurring in developing countries. Kenya has a high maternal mortality rate at 362 deaths per 100,000 births as compared to a target of 70 deaths per 100,00 births. On 1st June 2013, the Kenya government, made a declaration that delivery services were to be offered free of charge to encourage women to deliver under skilled health personnel. This was known as the free maternal health policy. It was developed in line with the government’s pursuit of universal access to healthcare across the country and provision of the highest standard of care possible. Since its implementation, there was paucity of data on evaluation of the policy’s effectiveness. This study sought to address the gaps in the policy with focus on patterns of delivery, challenges faced by health care workers and effects on health care financing. This was a qualitative study carried out at Machakos level five hospital among health care providers both in administrative and clinical work involved in implementation of the free maternity services. Data collection was done through interviews and focus group discussions and analysed using qualitative analysis software NVIVO 10. The results of this study showed that the policy met its primary objective of increasing hospital deliveries. However, there are issues in implementation due to lack of stakeholder involvement, limited commodities and infrastructure, increased workload and lack of understanding of the policy. In conclusion, there is need to re-evaluate the Free Maternal health policy and set up guidelines to include; improvement of health worker to patient ratio through capacity building, timely reimbursement of funds to ensure smooth running of the service, education of both community and implementers of the policy on what the policy entails. Further research is needed to assess financial sustainability of the policy.