Evaluation of Factors Associated With Utilization of Postnatal Care Services at Kajiado County: NHIF Linda Mama Programme

Abstract

Post-natal care has been demonstrated as an integral component in the continuum of care, as it greatly helps in reducing maternal and infant morbidity and mortality. However, the uptake of the post-natal services has been low despite the fact that these services are offered for free by the government through the Linda Mama program. The general objective was to evaluate factors associated with the utilization of post-natal care services in Kajiado County. The study examined socio-demographic characteristics of mothers, perception of mothers on Linda Mama PNC, knowledge and attitudes, and the availability of healthcare facility infrastructure. This is because there was low PNC utilization which was linked to upsurge of post-maternal deaths in Kajiado county. The study adopted Anderson behavioral model for health services utilization. A cross-sectional study using both qualitative and quantitative data collection methods. A target population of 6,322 mothers who had deliveries 1st April 2019 to 30th sept. 2019 in Kajiado County was considered. Additionally, there Key Interview Informants selected included a representation of the mothers receiving care at the facility, government official (local administration), a community elder, a sub county nursing officer, and a disease surveillance officer, were included in the study. The sample size of the mothers was determined using Heinisch formular to have 363 mothers that were selected using simple random method. The mothers answered questionnaires while the Key Informants were interviewed. The research instruments were pretested in nearby facilities in Machakos County as part of the Linda Mama program. Three types of validity such as content, criterion, and construct were examined and Cronbach Alpha was used in measuring reliability. Authority to carry out the research was sought from the KeMU university, NACOSTI and from the office of the county director of health sciences, Kajiado County. The findings on the perception of mothers were that, majority of them were not aware of the existence of free PNC services offered through the Linda mama program. The study findings further point out that only 12(4%) of the mothers knew that there were free PNC services offered under Linda mama program. It was also discovered that only 3(1%) of the mothers had actually utilized the PNC free services of the program. The study’s conclusion on socio-demographic characteristics of the mothers is that most mothers lacked money to buy nutritious food, so as to have more supply of breast milk and also pay for any emerging post-delivery complications related to the baby or their health. On the perception of mothers is that, majority of them were not aware of the existence of free PNC services offered through the Linda mama program. On knowledge and attitudes is that mothers made assumption that since they had prior experience in child bearing, they did not require the PNC services. On availability of infrastructure is that hospital did not have a proper documentation of the Linda mama PNC services. The study recommends that the hospital management should recruit added number of CHVs, nurses and nutritionists to offer mobile PNC services. Their services should involve offering vigorous sensitization trainings of Linda mama program services such as on the importance of PNC services. To ensure a smooth flow, the hospital management should empower work policies that allow frequent spot check audits of PNC service documentation.