Most maternal deaths should be preventable if women are provided with timely and appropriate care, particularly in the event of an emergency. To provide good care, services need to have resources, be accessible and responsive to women's needs. Information on how maternal services are delivered is a prerequisite for improving health system performance.
Methods: As part of a much larger survey, we assessed the quality and availability of maternal health services in a representative sample of 333 public and private facilities. We also interviewed 921 health workers and 501 clients and observed 512 antenatal consultations.
Results: Whereas most facilities in Kenya provided antenatal care, only 37% provided delivery care and of these 43% provided post abortion care and 28% caesarian sections. Although most facilities were equipped for providing routine care, many lacked medicines and supplies; only 44% of facilities had ANC cards and 10% lacked iron. Facilities were not well equipped for emergencies; only 47% of delivery facilities had emergency transport available and only 20% of delivery staff had ever had any refresher training managing complications. Less than 60% of hospitals had the essential equipment and medicines for haemorrhage and sepsis. More detailed results will be presented.
Discussion: This is one of the first surveys to systematically assess health system capacity to provide maternal health services. Whilst Kenyan facilities are equipped for providing normal care, there is an urgent need to improve emergency care and care for complications. The Kenya Ministry of Health are currently working on strategies to address this need.
Learning Objectives: By the end of the session participants should be able to: 1. Identify some of the important elements in evaluating maternal health services 2. List some of the key findings on the quality and availability of Kenyan maternal health services. 3. Discuss some of the policy and programme implications from a maternal health performance assessment.
Keywords: Maternal Care, Performance Measurement
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Services Provision Assessment(SPA) is a survey designed by Measure DHS and Measure Evaluation with the support of USAID. The surveys are implemented with technical assistance from both these projects (ORC Macro and the University of North Carolina)
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.