Determinants of quality of maternal child health services in the tier 3 public health facilities of Kisumu county after the declaration of free maternal health care.

Abstract

The goal of service delivery of any government is to provide quality essential priority health packages that are acceptable, affordable and accessible to all its citizens. The declaration of free maternal Health Care services by the National Government of Kenya is a positive step to fulfilling the affordability and to some extent accessibility aspects of Maternal and Child health service delivery. Kisumu County still has the highest proportion of mothers dying in the post-partum period with Maternal Mortality ratio at 597 per 100,000 live births, hospital delivery at 45.6% and immunization coverage at 68.6%. The determinants of Maternal Newborn Child Health (MNCH) services in Kisumu County Tier 3 health facilities are less understood as universal uptake of these services have not been realized especially the link between high post-partum deaths and high HIV prevalence. Most health facilities in Kisumu County are poorly equipped with the MNCH facilities; health staff are few and overburdened by the high admissions due to soaring disease incidences in the region. The current study therefore proposes to establish the determinants of quality of maternal and child health services offered in the Tier 3Public health facilities within Kisumu County in the face of free Maternal Health care services in Kenya. A descriptive cross section design will be adopted and the Study population will be mothers attending the MNCH Clinic and Health Care Workers. Quantitative data will be collected using structured questionnaires while qualitative data using Focused Group Discussion and Key Informant Interviews of MNCH Health Workers and Facility in-charges respectively, a total of 1033 mothers with 2+ ANC visit will be sampled randomly. Quantitative data arising from the study will be analyzed using Statistical Package for Social Sciences. Univariate statistics will be used to assess patterns of responses to the questionnaire items and matched to themes emerging from the FGDs. Chi-square (χ2) tests will be used to assess differences between categories and P-values of less than 0.02 will be considered significant. The findings of the study will highlight on health service provision strategies that will improved quality of MNCH services not only in Kisumu County but also in other health care facilities in the country