The effect of Kenya's free maternal health care policy on the utilization of health facility delivery services and maternal and neonatal mortality in public health facilities

• Published in: BMC pregnancy and childbirth 2018-03, Vol.18 (1), p.77-77, Article 77
• Main Authors: Gitobu, C M, Gichangi, P B, Mwanda, W O
• Format: Article
• Language: English
• Subjects: Adult; Delivery, Obstetric - economics; Delivery, Obstetric - legislation & jurisprudence; Delivery, Obstetric - statistics & numerical data; Fees & charges; Female; Free maternal health care policy; Health care policy; Health facilities; Health Facilities - statistics & numerical data; Health Plan Implementation - statistics & numerical data; Health Policy - economics; Health Policy - legislation & jurisprudence; Health services; Humans; Infant; Infant mortality; Infant Mortality - trends; Infant, Newborn; Kenya; Maternal & child health; Maternal Health Services - economics; Maternal Health Services - legislation & jurisprudence; Maternal Health Services - statistics & numerical data; Maternal mortality; Maternal Mortality - trends; Maternal mortality ratio; Neonatal mortality rate and health facility delivery services utilization; Newborn babies; Patient Acceptance of Health Care - statistics & numerical data; Pregnancy; Public health
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-018-1708-2

Kenya abolished delivery fees in all public health facilities through a presidential directive effective on June 1, 2013 with an aim of promoting health facility delivery service utilization and reducing pregnancy-related mortality in the country. This paper aims to provide a brief overview of this policy's effect on health facility delivery service utilization and maternal mortality ratio and neonatal mortality rate in Kenyan public health facilities. A time series analysis was conducted on health facility delivery services utilization, maternal and neonatal mortality 2 years before and after the policy intervention in 77 health facilities across 14 counties in Kenya. A statistically significant increase in the number of facility-based deliveries was identified with no significant changes in the ratio of maternal mortality and the rate of neonatal mortality. The findings suggest that cost is a deterrent to health facility delivery service utilization in Kenya and thus free delivery services are an important strategy to promote utilization of health facility delivery services; however, there is a need to simultaneously address other factors that contribute to pregnancy-related and neonatal deaths.