Effect of health systems strengthening in influencing maternal and neonatal health outcomes in Bungoma County Kenya
maternal and neonatal health statusrnindicators have steadily improved over time inrnKenya. Significant challenges remain includingrnpersistent inequities between populationrnsubgroups and a health system that deliversrnvariable quality care and inconsistent access torncare.
This paper highlights results of an ex-postrnevaluation to assess the impact of maternal andrnhealth systems strengthening intervention tornimprove newborn health outcomes in BungomarnCounty Kenya focusing on access to and quality ofrnmaternal and neonatal care.
the studyrndesign was quasi-experimental using householdrnsurveys to assess outcomes at baseline and endline. Stratified cluster sampling was used to identifyrnhouseholds based on heath facility catchmentrnareas. Inclusion criteria were women aged 18-49.rnChi-square and fishers exact tests were used.rnPatched-up design was used to compare outcomesrnbefore and after the intervention and interventionrnand control sub-counties.
provision ofrntransport vouchers decreased barriers to accesstornhealth care resulting in an increased number ofrndeliveries in health facilities. Women in the end-linerngroup were 95 more likely to deliver at a healthrnfacility compared to 74 at baseline. Thernintervention improved potential and effectivernaccess to antenatal care as well as deliveries inrnhealth facilities. This positively impacted quality ofrncare provision in the sub-counties.
The intervention had an impact on improvingrnaccess to care and delivering better quality of carernto pregnant mothers in Bungoma. Key elementsrninclude reducing cost barriers to generate demandrnand enhancing the capacity of the health facilitiesrnto deliver moderately improved quality of care.rnWhat is known about this topicrn Access to delivery services is hindered onrndemand side by lack of income lack ofrntransport and lack of birth preparedness onrnthe demand side and quality of care in termsrnof waiting time and provider clientrninterpersonal relationshipsrn Poverty lack of transport and poorrntreatment by nurses as some of the barriersrnin the utilization of maternal and childrnhealth servicesrn Distance poor roads and difficulty inrnobtaining transport as hindering factors andrnquality of treatment and disrespectful andrnunfriendly care offered at health facilities
Publication Information
Focus County(s):
Bungoma County
Programme Area(s):
Sexual, Reproductive, Adolescent & Child Health
Research Priority Area(s):
Disease Domain(s):
maternal and neonatal health
Document History:
Publication Date: 04.Jun.2021
Conference Title: