•Since free maternity services were put in place in 2013, reimbursement by the Health Ministry has been problematic and thus continues to compromise quality
•Others use traditional medicine and prefer home deliveries
Lack of basic supplies in hospitals has led to a reduction of women seeking services under the Free Maternity Services programme, a new report shows.
The basics include cotton wool, blades and syringes.
Some women are now seeking the services of traditional birth attendants whose role is not properly recognised in the formal healthcare systems.
Others use traditional medicine and prefer home deliveries which make them feel ashamed to reveal the unfavourable birth outcomes.
The report further shows a complete disconnect between what is expected to happen under the programme and what happens in reality.
This is contained in the report, 'The Impact of Government Supported Maternal Health Programs on Maternal Health Outcomes in Kenya; hits, misses and lessons' which was released yesterday.
The study was conducted by Open Society Initiative for Eastern Africa with an aim to review the impact of free maternity services on maternal mortality in Nairobi, Kilifi and Migori counties.
Image: MAGDALINE SAYA
The report shows the number of women seeking antenatal care services increased from 2013 after the declaration of free maternity services, but there was a decrease between 2015 and 2016.
In Bamba Subcounty Hospital, there was a dip in the number of women who received Intermittent Preventive Treatment 1 (IPT1) and IPT2 in 2014, compared to the period between 2011 and 2013.
In Malindi Subcounty Hospital, there was an increase in the number of new ANC patients, ANC visits, total pregnancies registered and the number of women who received the IPT1 and IPT2. The numbers dipped in 2015.
“The reducing numbers could be an indication of dissatisfaction with services offered as a result of low quality due to large numbers seeking services beyond the capacity of the available healthcare personnel,” the report states.
According to the report, since free maternity services were introduced in 2013, reimbursement by the Health ministry has been problematic and thus continues to compromise quality.
Since reimbursements were not forthcoming as expected, facilities provided poor quality services. Lack of basic supplies also forced providers to refer patients to private health facilities where they were expected to pay for the services rendered.
“The free maternity declaration has been seen as focusing mainly on reducing financial barriers without considering other important impediments like distance to the health facilities, staff attitude as well as availability of adequate equipment supplies as key factors in accessing maternal health services,” the report states.
In terms of staffing, the report notes that the hiring of staff in some facilities has been politicised. This led to the hiring of incompetent staff, compromising on quality.
The situation has been worsened by increased strikes that have left patients unattended.
“We deliver between 2,000 and 3,000 mothers a month at Pumwani Hospital. We are literally clogged, and we would discharge patients early to create room for others. When you have like 60 women in labour wards with only six nurses, what care can you provide to each of them?” a senior official at Pumwani Maternity Hospital said.
“I wish the mothers can take some bit of responsibility. They are pregnant for nine months but still come to the hospital with completely nothing including the baby’s clothes. They should be made to pay at least Sh500 to increase responsibility,” a healthcare provider at Mbagathi Hospital said.
The report recommends that the cost of healthcare services must be regulated and the exploitation that has been witnessed through private healthcare insurance checked.
In addition, the report recommends that free maternity packages should include basics such as food, basins, sanitary towels, baby shawls, diapers and baby clothes.
This, it says, will encourage more women to deliver in hospitals.