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Efficacy of Free Maternity Health Policy at Machakos Level 5 County Hospital (Kenya) An exploratory Qualitative study

Elvis Gichuhi and Adelaide Lusambili

Background: In 2013, the Government of Kenya introduced the country’s Free Maternal Health Policy (FMHP). This policy funded free maternity services performed by trained health care professionals. In 2018, five years after the introduction of the FMHP, the country still reported 22.6 per 1000 neonatal deaths, and a UNICEF (2018) report ranked Kenyan maternal health care as one of the ten worst-performing in Sub-Saharan Africa. There is need to understand the efficacy of the FMHP to identify gaps in areas of improvement as well as to inform future policy on maternal health care practices.

Study aims: To understand the efficacy of Kenya’s Free Maternal Health Policy using a cases study of Machakos Level Five Hospital (Kenya).

Methodology: In-depth and Focus Group Discussions (FGDs) with health care professionals implementing the FMHP.

Data analysis: Data were analysed using NVIVO 10 software.

Findings: The findings revealed that, although the FMHP led to an increase in hospital deliveries, overall the implementation and delivery of the policy was marred by organisational factors and poor planning.

Conclusions: There is an urgent need to re-evaluate the Free Maternal Health Policy in order to set up guidelines to improve its implementation. Goals for improving service delivery should include: (1) lowering staff: patient ratio; (2) reimbursing service providers in a timely fashion, to ensure smooth service delivery; (3) educating both communities and implementers about FMHP requirements and goals; (4) instituting a regular monitoring process to ensure FMHP goals are being met.