Uptake of universal health coverage provided, maternal, neonatal and child health services, in Machakos County Kenya
Keywords:MNCH, UHC, Uptake, WRA
Background: The Universal Health Coverage (UHC) offers an essential package of health services to citizens while protecting them financially in case of an illness. It has been given a top priority globally as a health-related aim. In Kenya, whereas MNCH services have continued to attract investment over the years, reports still show high rates of maternal and child mortality. The study sought to assess the level of uptake of universal health coverage provided MNCH services and the associated factors.
Methods: This was a cross-sectional study undertaken in 422 households in Machakos Sub-County on women of reproductive age (WRA). The data was collected using questionnaires. Multiple logistic regression with (p<0.05) at 95% CI was used for inferential statistics.
Results: The results show that all respondents had sought at least one MNCH service. Time taken to reach a health facility (OR 12.26; 95% CI 1.07 to 140.48) and feeling that a CHV could attend to them during an emergency (OR 4.14; 95% CI 1.23 to 13.91) were significant patient related factors. Supply side factors found to be significant were visit from a CHV (OR 125.93; 95% CI 18.37 to 863.27), feeling that services were of quality (OR 684.411; 95% CI 50.65 to 9248.93, adequacy of staff (OR 1.00; 95% CI 1.0004 to 0.021 and hospital commodities (OR 19.83; 95% CI 1.67 to 235.93). Demographic factors established to be significant were marital status, education level, occupation and monthly income.
Conclusions: Patient-related, supply-side and demographic factors had a significant influence on uptake of UHC provided MNCH services.
WHO, "Health Financing Policies in Fragile and Conflict Affected Setting," 2018a. Available at: https://www.who.int/health_financing/universal_coverage_definition/en/ Accessed 15th April 2019.
WHO, "Universal Health Coverage-Global Health Care Coverage," 2019a, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/ universal-health-coverage-(uhc). Accessed 10th June 2021.
S Ifeagwu SC, Yang JC, Parkes-Ratanshi R, Brayne C. Health financing for universal health coverage in Sub-Saharan Africa: a systematic review. Glob Heal Res Pol. 2021;6(8):1-9.
CDC. Maternal and Child Health, 2014. Available at: https://www.cdc.gov/globalhealth/mch/ index.htm. Accessed 14th January 2021.
WHO. WHO 2019 family planning factsheet, 2019d. Available at: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception. Accessed 13th December 2020.
KHHES. Kenya Household Health Expenditure and Utilization Survey, 2013. Available at: https://africaopendata.org/dataset/kenya-household-health-expenditure-and-utilization-survey-khheus-2013#:~:text=2013%20KHHEUS%20explores%20the%20health-seeking%20behavior%2C%20use%20 of,collects%20data%20from%20the%20country%E2%80%99s%2047%20newly-created%20counties. Accessed 10th November 2023.
WHO. The Abuja Declaration, 2001. Available at: https://apps.who.int/iris/bitstream/handle/10665/341162/WHO-HSS-HSF-2010.01-eng.pdf?sequence=1. Accessed 10th November 2023.
KNHA, "Health Policy- FY 2015/16," 2016. Available at: http://www.healthpolicyplus.com/ns/ pubs/16339-16616_KenyaNHAmainreport.pd Accessed on 10th November 2019.
KNBS, "2019 Kenya Population and Housing Census," 2019. Available at: https://www.knbs. or.ke/2019-kenya-population-and-housing-census-reports/ Accessed on 13th January 2021.
Unnikrishnan B, Rathi P, Sequeira RM, Rao KK, Kamath S, K MA. Awareness and uptake of maternal and child health benefit schemes among the women attending a district hospital in coastal South India. J Heal Manag. 2020;22(1):14-24.
Njuguna J, Kamau N, Muruka C. Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya. BMC Heal Serv Res. 2017;17(1):1-6.
Bhatt H, Tiwari S, Ensor T, Ghimire DR, Gavidia T. Contribution of Nepal’s free delivery care policies in improving utilisation of maternal health services. Inter J Heal Pol Manag. 2018;7(7):645.
Gonie A, Wudneh A, Nigatu D, Dendir Z. Determinants of family planning use among married women in bale eco-region, Southeast Ethiopia: a community based study. BMC Wom Heal. 2018;18(1):1-0.
Hu Y, Chen Y, Liang H, Wang Y. An overview of coverage of BCG vaccination and its determinants based on data from the coverage survey in Zhejiang Province. Inter J Environ Res Pub Heal. 2018;15(6):1155.
Reiher A, Mohammadnezhad M. A qualitative exploration of behavioral factors affecting mothers of malnourished children under 5 years old in Kiribati. F1000Research. 2019;8.
Damtew D, Worku F, Tesfaye Y, Jemal A. Availability of lifesaving maternal and child health commodities and associated factors in public and private health facilities of Addis Ababa, Ethiopia. Heal Servi Res Manag Epidemiol. 2019;6:2333392819892350.
Mugo NS, Dibley MJ, Damundu EY, Alam A. Barriers faced by the health workers to deliver maternal care services and their perceptions of the factors preventing their clients from receiving the services: a qualitative study in South Sudan. Mat Chi Heal J. 2018;22:1598-606.
Shroff ZC, Marten R, Ghaffar A, Sheikh K, Bekedam H, Jhalani M, et al. On the path to Universal Health Coverage: aligning ongoing health systems reforms in India. BMJ Glob Heal. 2020;5(9):e003801.
Khan JA, Ahmed S, Evans TG. Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh—an estimation of financial risk protection of universal health coverage. Health Pol Plann. 2017;32(8):1102-10.
Barasa E, Rogo K, Mwaura N, Chuma J. Kenya National Hospital Insurance Fund Reforms: implications and lessons for universal health coverage. Heal Syst Ref. 2018;4(4):346-61.
Okumu D. Customer Satisfaction Among the Nhif Members: Case of Homa Bay County, Kenya, 2018.
Myint AN, Liabsuetrakul T, Htay TT, Wai MM, Sundby J, Bjertness E. Impoverishment and catastrophic expenditures due to out-of-pocket payments for antenatal and delivery care in Yangon Region, Myanmar: a cross-sectional study. BMJ open. 2018;8(11):e022380.
Radovich E, Dennis ML, Barasa E, Cavallaro FL, Wong KL, Borghi J, et al. Who pays and how much? A cross-sectional study of out-of-pocket payment for modern contraception in Kenya. BMJ open. 2019;9(2):e022414.
Meda IB, Baguiya A, Ridde V, Ouédraogo HG, Dumont A, Kouanda S. Out-of-pocket payments in the context of a free maternal health care policy in Burkina Faso: a national cross-sectional survey. Health Economics Review. 2019;9(1):1-4.
Aseyo RE, Mumma J, Scott K, Nelima D, Davis E, Baker KK, et al. Realities and experiences of community health volunteers as agents for behaviour change: evidence from an informal urban settlement in Kisumu, Kenya. Hum Resou Heal. 2018;16(1):1-2.
Joarder T, Chaudhury TZ, Mannan I. Universal health coverage in Bangladesh: activities, challenges, and suggestions. Advan Pub Heal. 2019;2019.