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肯尼亚免费孕产妇保健政策对公共卫生设施中利用卫生机构分娩服务以及孕产妇和新生儿死亡率的影响。

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.

机构信息

Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya.

Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.

出版信息

BMC Pregnancy Childbirth. 2018 Mar 27;18(1):77. doi: 10.1186/s12884-018-1708-2.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

肯尼亚通过总统指令于 2013 年 6 月 1 日取消了所有公共卫生机构的分娩费用,旨在促进卫生机构分娩服务的利用并降低该国的妊娠相关死亡率。本文旨在简要概述该政策对肯尼亚公共卫生机构分娩服务利用和孕产妇死亡率以及新生儿死亡率的影响。

方法

对肯尼亚 14 个县的 77 个卫生机构在政策干预前 2 年和后 2 年的卫生机构分娩服务利用、孕产妇和新生儿死亡率进行了时间序列分析。

结果

发现医疗机构分娩数量有统计学意义的显著增加,而孕产妇死亡率和新生儿死亡率的比例没有显著变化。

结论

研究结果表明,在肯尼亚,费用是阻碍利用医疗机构分娩服务的一个因素,因此免费分娩服务是促进利用医疗机构分娩服务的一项重要策略;然而,还需要同时解决导致妊娠相关和新生儿死亡的其他因素。

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