Tuesday, February 9, 2016

Implementation Challenges of Free Maternity Services Policy in Kenya: The Health Workers’ Perspective

Introduction: Kenya implemented the policy of free maternity services to reduce maternal mortality and morbidity. For successful implementation of this policy, there is need to monitor the implementation progress, identify the challenges and mitigate them and determine better strategies for implementation based on emerging implementation issues. This study was carried out to determine the challenges facing policy implementation and strategies for better implementation.

Methods: this was a cross-sectional descriptive study carried at the Rift Valley Provincial General Hospital (RVPGH) and Bondeni maternity. All the staff who work at Bondeni Maternity (including nursing officer in-charge) were included in the study. All the staff who work at the Maternity Unit of the RVPGH were included in the study, as well as the Medical Superintendent of the facility. A total of 110 respondents were sampled. A questionnaire and interview guide were used to collect data. Data was analyzed using SPSS software.

Results: a response rate of 91% (n=100) was achieved. Major implementation challenges include inadequate supplies (86%), inadequate funding (38%), staff shortage (92%), lack of motivation among health workers (62%), overwhelming workload (89%) and abuse of services by clients (32%). Strategies for better implementation include employment of more staff, motivation of health workers, improvement in policy financing, training of health workers and provision of adequate supplies.

Conclusion: implementation of free maternity services policy in Kenya is facing challenges but there exists strategies, which, if implemented, will help address these challenges.

Table 2: comparison of implementation challenges between the two facilities

Facility
P-values
NakuruPGH (%)
Bondeni Maternity (%)
Financial challenges
Yes
29 (33.7)
9 (64.3)
0.029
No
57 (66.3)
5 (35.7)
Supplies challenges
Yes
72 (83.7)
14 (100)
0.208
No
14 (16.3)
0 (0.0)
Health workers inadequate skills
Yes
14 (16.3)
3 (21.4)
0.702
No
72 (83.7)
11 (78.6)
Staff shortage challenges
Yes
78 (90.7)
14 (100)
0.596
No
8 (9.3)
0 (0.0)
Overwhelming work
Yes
77 (89.5)
12 (85.7)
0.65
No
9 (10.5)
2 (14.3)
Rude client
Yes
24 (27.9)
2 (14.3)
0.346
No
62 (72.1)
12 (85.7)
Abuse of free services
Yes
24 (27.9)
8 (57.1)
0.03
No
62 (72.1)
6 (42.9)
Lack of managerial support
Yes
9 (10.5)
9 (64.3)
0.001
No
77 (89.5)
5 (35.7)
  
Full article at:   http://goo.gl/ZOPwGS

By:  Emmanuel Wekesa Wamalwa1,&
1Department of Health Systems Management, Kenya Methodist University




No comments:

Post a Comment