Njuguna John, Kamau Njoroge, Muruka Charles
Mukurwe-ini sub-County Public Health Office, Mukurwe-ini, Kenya.
HEADS Alliance, Kwale County, Kenya.
BMC Health Serv Res. 2017 Jun 21;17(1):429. doi: 10.1186/s12913-017-2376-z.
Kenya has a high maternal mortality rate. Provision of skilled delivery plays a major role in reducing maternal mortality. Cost is a hindrance to the utilization of skilled delivery. The Government of Kenya introduced a policy of free delivery services in government facilities beginning June 2013. We sought to determine the impact of this intervention on facility based deliveries in Kenya.
We compared deliveries and antenatal attendance in 47 county referral hospitals and 30 low cost private hospitals not participating in the free delivery policy for 2013 and 2014 respectively. The data was extracted from the Kenya Health Information System. Multiple regression was done to assess factors influencing increase in number of deliveries among the county referral hospitals.
The number of deliveries and antenatal attendance increased by 26.8% and 16.2% in county referral hospitals and decreased by 11.9% and 5.4% respectively in low cost private hospitals. Increase in deliveries among county referral hospitals was influenced by population size of county and type of county referral hospital. Counties with level 5 hospitals recorded more deliveries compared to those with level 4 hospitals.
This intervention increased the number of facility based deliveries. Policy makers may consider incorporating low cost private hospitals so as to increase the coverage of this intervention.
肯尼亚孕产妇死亡率很高。提供熟练的接生服务在降低孕产妇死亡率方面发挥着重要作用。费用是熟练接生服务利用的一个障碍。肯尼亚政府从2013年6月起在政府设施中推行了免费接生服务政策。我们试图确定这一干预措施对肯尼亚设施接生的影响。
我们分别比较了47家县级转诊医院和30家未参与2013年和2014年免费接生政策的低成本私立医院的接生情况和产前检查情况。数据从肯尼亚卫生信息系统中提取。进行多元回归以评估影响县级转诊医院接生数量增加的因素。
县级转诊医院的接生数量和产前检查次数分别增加了26.8%和16.2%，而低成本私立医院的接生数量和产前检查次数分别下降了11.9%和5.4%。县级转诊医院接生数量的增加受到县人口规模和县转诊医院类型的影响。与设有4级医院的县相比，设有5级医院的县记录的接生数量更多。
这一干预措施增加了设施接生的数量。政策制定者可考虑将低成本私立医院纳入其中，以扩大这一干预措施的覆盖范围。
