Satisfaction Levels With Maternity Services Among Postnatal Women Attending Public Hospitals In Nairobi City County, Kenya

ABSTRACT

Globally, the rate of maternal mortality is unacceptably on the rise. A considerable

number of women are dying from pregnancy or child birth related complications

across the world. Many initiatives have been intensified on policy intervention to curb

the high cases of maternal mortality. Delivery in unhygienic conditions without the

assistance of a skilled birth attendant may lead to adverse health outcomes. Maternal

mortality rates in Kenya remain high at 362 per 100,000 live births. Only 62% of

women deliver under the care of a skilled provider indicating a deficiency in the

quality of care. The government of Kenya introduced the policy of Free Maternity

Services to all women attending public health facilities by June 2013 to increase

access to skilled care delivery and help reduce the rate of maternal mortality and

morbidity in the country. The study sought to establish the satisfaction levels with free

maternity services among postnatal women attending public hospitals in Nairobi City

County. The study mainly focused on the individual client characteristics, the health

provider related factors, the health system factors and the obstetric experiences

associated with maternal satisfaction. The study adopted a descriptive cross-sectional

facility-based study design which encompassed use of both quantitative and

qualitative data collection methods. Quantitative data was collected using pretested

questionnaires administered to post-natal women by trained research assistants.

Qualitative data was collected through Focused Group Discussion sessions with

patients and Key Informant Interviews with care providers. A sample size of 417

postnatal mothers was proportionally selected from each hospital through systematic

random sampling and interviewed. Kenyatta National Hospital, Pumwani maternity,

Mbagathi and Mama Lucy Kibaki hospitals were purposively selected. Necessary

approvals were sought from relevant authorities and informed consent obtained from

research participants prior to data collection. Descriptive data was analyzed using

Statistical Package for Social Sciences version 20.0 in conjunction with Microsoft

Excel program. Frequency distribution tables, graphs and pie-charts were used for

data presentation. Qualitative data was presented as direct quotes or narrations from

respondents and triangulated with quantitative results. Inferential statistics were

calculated using Chi-Square tests (p