The differential effect of the free maternity services policy in Kenya
| Autor: | Samson O. Adoka, Henry O. Owuor, Stephen Amolo Asito |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Kenya region Primary health care lcsh:Medicine skilled care delivery 030501 epidemiology deliveries attended by skilled birth attendants Health Services Accessibility Nyamira County 03 medical and health sciences 0302 clinical medicine Health facility Pregnancy Environmental health Medicine Humans Maternal health Maternal Health Services 030212 general & internal medicine Original Research Government business.industry lcsh:Public aspects of medicine Health Policy lcsh:R Public Health Environmental and Occupational Health Interrupted time series Facility type Differential (mechanical device) lcsh:RA1-1270 General Medicine Delivery Obstetric Kenya sub-county Female Health information facility type 0305 other medical science Family Practice business free maternity services policy |
| Zdroj: | African Journal of Primary Health Care & Family Medicine African Journal of Primary Health Care & Family Medicine, Volume: 11, Issue: 1, Pages: 1-6, Published: 2019 African Journal of Primary Health Care & Family Medicine, Vol 11, Iss 1, Pp e1-e6 (2019) |
| ISSN: | 2071-2936 |
| Popis: | Background: The Government of Kenya introduced the free maternity services (FMS) policy to enable mothers deliver at a health facility and thus improve maternal health indicators. Aim: The aim of this study was to determine if there was a differential effect of the policy by region (sub-county) and by facility type (hospitals vs. primary healthcare facilities [PHCFs]). Setting: The study was conducted in Nyamira County in western Kenya. Methods: This was an interrupted time series study where 42 data sets (24 pre- and 18 post-intervention) were collected for each observation. Monthly data were abstracted from the District Health Information System-2, verified, keyed into and analysed by using IBM-Statistical Package for the Social Sciences (SPSS-17). Results: The relative effect of the policy on facility deliveries in the county was an increase of 22.5%, significant up to the 12th month ( p < 0.05). The effect of the policy on deliveries by region was highest in Nyamira North and Masaba North ( p < 0.001 up to the 18th month). The effect was larger (46.5% vs. 18.3%) and lasted longer (18 months vs. 6 months) in the hospitals than in the PHCFs. The increase in hospital deliveries was most significant in Nyamira North (61%; p < 0.001). There was a medium-term effect on hospital deliveries in Borabu (up to 9 months) and an effect that started in the sixth month in Manga. The relative effect of the policy on facility deliveries in PHCFs was only significant in Nyamira North and Masaba North ( p < 0.001). Conclusion: The effect of the FMS policy was varied by region (sub-county) and by facility type. |
| Databáze: | OpenAIRE |
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